COSMOS: Multivitamins linked to improved memory, slower age-related cognitive decline

By Stephen Daniells

- Last updated on GMT

A meta-analysis of data from 5,000 people showed “clear evidence” for the benefits of a multivitamin on cognitive function.   Image  © PixelsEffect / Getty Images
A meta-analysis of data from 5,000 people showed “clear evidence” for the benefits of a multivitamin on cognitive function. Image © PixelsEffect / Getty Images

Related tags multivitamins Dietary supplements Cognitive decline Memory healthy aging Cognitive function

Daily multivitamin supplementation may boost episodic memory and slow cognitive in older adults, says new data published in the American Journal of Clinical Nutrition.

A meta-analysis of data from 5,000 people showed “clear evidence” for the benefits of a multivitamin (MVM) on cognitive function and episodic memory, according to data from the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), a large-scale, nationwide, randomized trial evaluating the potential health benefits of a cocoa extract and multivitamin supplements.

“Regarding clinical importance, the effect of daily MVM supplementation on global cognition over a duration of 2–3 [years] may translate to a reduction in cognitive aging by 2 [years] compared with placebo,” wrote the researchers, led by Chirag Vyas, MBBS, MPH, from Massachusetts General Hospital.

“Our findings warrant consideration by clinical guidelines committees for the role of daily MVM use in preventing cognitive decline in older adults.”


The data appears to confirm earlier findings from COSMOS-Mind linking daily multivitamins to slowing of cognitive decline​.

Although limited to older adults, the data will be welcomed by the millions of Americans who regularly take a multivitamin. According to data from the Council for Responsible Nutrition’s 2022 Consumer Survey on Dietary Supplements​, multivitamins are the most used supplement in the US, with 70% of all supplement users reporting that they had taken a multivitamin in the past 12 months.

The Cosmos studies used the Centrum Silver (Pfizer Consumer Healthcare, now Haleon) brand of multivitamins.

The same research team recently reported​ that the cocoa extract used in COSMOS was also associated with some benefits for the aging brains. Cocoa consumption was linked to an improved cognition in adults over the age of 60 with habitually poorer diets but had no overall brain benefits in those with healthier dietary patterns.

Crossword senior © Daisy-Daisy  Getty Images
“Cognitive decline is among the top health concerns for most older adults, and a daily supplement of multivitamins has the potential as an appealing and accessible approach to slow cognitive aging,” said Chirag Vyas, Massachusetts General Hospital. Image © Daisy-Daisy / Getty Images

New data and meta-analysis

The new paper details two sets of data: The COSMOS-Clinic, an in-person in-clinic cognitive study of 573 participants, and a meta-analysis of data from 5,000 people included in three separate COSMOS studies—COSMOS-Clinic, COSMOS-MIND and COSMOS-Web—with non-overlapping participants (ranging from two to three years in duration).

For COSMOS-Clinic, the researchers observed a modest benefit for the multivitamin, compared to placebo, on global cognition over two years. They also reported a statistically significant benefit of multivitamin supplementation for change in episodic memory but not in executive function/attention.

Results from the meta-analysis showed strong evidence of benefits for both global cognition and episodic memory. The authors estimated that the daily multivitamin slowed global cognitive aging by the equivalent of two years compared to placebo.

“The meta-analysis of three separate cognition studies provides strong and consistent evidence that taking a daily multivitamin, containing more than 20 essential micronutrients, helps prevent memory loss and slow down cognitive aging,” Vyas said.

JoAnn Manson, MD, DrPH, from Brigham and Women’s Hospital and co-leader of the overall COSMOS trial, said: “The finding that a daily multivitamin improved memory and slowed cognitive aging in three separate placebo-controlled studies in COSMOS is exciting and further supports the promise of multivitamins as a safe, accessible and affordable approach to protecting cognitive health in older adults.”

Strengthen consumer confidence

The findings were welcomed by the Council for Responsible Nutrition (CRN), which issued the following statement: "CRN is impressed by this recently published research further demonstrating the benefits of multivitamin supplementation on memory and cognitive aging. CRN agrees with the study authors that the results are stunning and consistent.

“These results should strengthen consumer confidence in the value of daily multivitamin supplementation.”

Source: American Journal of Clinical Nutrition
Published online ahead of print, doi: 10.1016/j.ajcnut.2023.12.011
“Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS”
Authors: C.M. Vyas et al.