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Taking a daily multivitamin to help ward off cognitive decline and dementia as we age has generated some buzz lately. The source of this excitement is the COSMOS trial and its related sub-studies. But do the findings live up to the hype?

Christopher Labos, MD, MSc, of McGill University in Montreal, has analyzed the results of the COSMOS (COcoa Supplement and Multivitamin Outcomes Study) studies.

  • The studies, co-funded by Mars, the candy bar company, do not support multivitamins for averting age-related cognitive decline or dementia.
  • Similarly, the studies found no evidence that chocolate reduces cardiovascular events.

The following is a summary of his analysis.

Why it matters

If the findings held up, millions worldwide could potentially stave off dementia and enjoy many more years of healthy cognition and independence later in life. But the evidence is far from conclusive.

Treating hearing loss, a proven strategy for reducing the risk of dementia.

The big picture

The main COSMOS trial found no benefit from multivitamins to prevent major diseases.

However, findings from the two sub-studies, COSMOS-Mind and COSMOS-Web, paint a contradictory picture of cognitive outcomes. Unlike previous negative findings from studies like ARED and PREVENTion, these sub-studies showed hints of benefit for participants taking multivitamins.

But how much benefit?

A closer look

While the COSMOS-Mind study found a statistically significant 0.07 improvement in cognitive scores for the multivitamin group, experts question whether this tiny gain would make any practical difference in people's lives.

For comparison, this 0.07 z-score shift is less than one-tenth the z-score difference between average cognitive performance and a diagnosis of mild cognitive impairment.

The intrigue

The COSMOS sub-study findings got attention because they contradicted prior negative data on vitamins and dementia risk from trials like ARED, WACS, and PREVENTion with PREADVISE.

Exercise, a proven strategy for cognitive health.  

Reality check

The cognitive benefits of multivitamins remain unproven based on the evidence. The small statistical changes in the COSMOS sub-studies are not meaningful protection for cognitive health.

  • For now, invest in proven prevention strategies like regular exercise and treating hearing loss.
  • The COSMOS findings may provide clues for researchers to refine and test supplements in future studies.

Treating hearing loss, a proven way to reduce your risk of dementia

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Go deeper: Multivitamins and Dementia: Untangling the COSMOS Study Web →

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