Taking a variety of micronutrients can improve cognition in older adults

The "Investigation Report on the Awareness and Demand of Alzheimer's Disease in China" was recently released
.
The survey report shows that the total awareness rate of Alzheimer's disease (AD) in China is more than 90%, but the active consultation rate is only more than
10%.
These diseases affect more than 46 million people worldwide, so there is an urgent need to identify effective treatment strategies to improve cognitive function to reduce the heavy social burden
associated with AD and dementia-related diseases.
The FDA has not approved any interventions to prevent cognitive decline in asymptomatic older adults, and to date, there is insufficient evidence to support the clinical benefit
of any drug treatment for mild cognitive impairment in adults.
Developing a safe, affordable intervention to protect cognitive function in older adults from decline is an urgent public health priority
.

In a recent study published in the journal Alzheimer's and Dementia, researchers in the United States recruited 2262 participants to evaluate the cognitive enhancement effects
of regular use of cocoa extract (CE) and multivitamin-mineral (MVM) in older adults in a randomized controlled trial (RCT).
It was found that taking a daily multivitamin-mineral tablet may slow the natural trend
of cognitive decline with age.

For 3 consecutive years, the team conducted phone-based cognitive tests to assess general cognitive, executive and memory functions
.
The COSMOS-Mind trial is a large practical, placebo-controlled, 2×2 factor 2 clinical trial to test the effects
of daily CE and/or MVM supplementation for cardiovascular and cancer-related diseases 。 Its main findings were the Global Cognitive Synthesis (GCC), reported as z-scores and derived from average scores across tests, including TICS (cognitive status telephone interviews, minute delayed recall of short and long 40-word lists), Part B of the verbal cue test (OTMT-B), immediate recall of stories (SRI) and delay (SRII), number span (NS), number ordering test (DOT), and verbal fluency (VF).

The higher the score, the better
the performance.
Secondary outcomes included a combination of
episodic memory and executive function.
The tertiary findings were the Simplified Geriatric Depression Scale (GDS-SF) and the Cognitive Change Index (CCI).

In addition, the COSMOS-Mind trial monitored adverse events (AEs) and gave those documented observations of cognitive assessments to the trial team
.
Using the intention-to-treat (ITT) approach, the primary endpoint was change in GCC after 3 years of CE and the secondary endpoint was change
in GCC at 3 years after taking MVM supplementation.
The researchers also evaluated the effects
of the two treatments on memory and executive function.

Eligibility criteria for the COSMOS-Mind trial include: no prior history of MI (myocardial infarction) or stroke; no previous history of cancer in the past two years; no history of serious illness that precludes participation; no cocoa or mineral/vitamin supplements were used during RCTs; Cocoa or caffeine allergy was not documented; ≥ successful placebo trial at 2 months, intervention adherence ≥ 75%, without concurrent participation in other RCTs
.
In addition, COSMOS-Mind trial eligibility includes: patient age≥ 65 years; Does not use insulin; Ability to
complete a telephone cognitive assessment.
The COSMOS-Mind trial was conducted randomly using a computer-generated allocation list, and all participants, inspectors, and investigators were unaware
of the intervention.
Linear mixed-effects models are used for analysis
.

The results of the study found that CE had no significant effect on cognition (mean z-score of 0.
03).

Conversely, daily MVM supplementation showed a statistically significant cognitive (GC) benefit (mean z-score 0.
1) compared to placebo, which was most prominent in adults with cerebrovascular disease (CVD) (mean z-scores of 0.
06 and 0.
14 for negative and positive histories, respectively).

Taking MVM also has some benefits for improving memory and executive function, with average z-scores of 0.
1 and 0.
1
, respectively.
CE did not alter the cognitive benefit of MVM, and no adverse events
were reported during the trial.

In conclusion, the findings suggest that taking CE daily for 3 years has no cognitive benefits
.
In contrast, daily vitamin-mineral supplementation for 3 years improved overall cognition, episodic memory, and executive function
in older adults.
In particular, the benefits of vitamin-mineral supplements are more pronounced
in patients with cardiovascular disease.

(Source: BioValley)

China Food News (October 12, 2022, Edition 03)

(Editor: Han Songyan).