Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial.
Am J Clin Nutr
; 119(1): 39-48, 2024 Jan.
Article
de En
| MEDLINE
| ID: mdl-38070683
ABSTRACT
BACKGROUND:
Some prior randomized clinical trials (RCTs) that tested the effects of cocoa extract (CE), a source of flavanols, on late-life cognition have yielded promising findings. A long-term RCT using in-person neuropsychological tests covering multiple cognitive domains may clarify the cognitive effects of CE.OBJECTIVES:
To test whether daily supplementation with CE, compared with placebo, produces better cognitive change over 2 y.METHODS:
The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a 2 × 2 factorial RCT of CE [500 mg flavanols/d, including 80 mg (-)-epicatechin] and/or a daily multivitamin-mineral supplement for cardiovascular disease and cancer prevention among 21,442 United States adults aged ≥60 y. There were 573 participants in the clinic subcohort of COSMOS (that is, COSMOS-Clinic) who completed all cognitive tests at baseline; of these, 492 completed 2-y follow-up assessments. The primary outcome was global cognition (averaging z-scores across 11 tests). Secondary outcomes were episodic memory and executive function/attention. Repeated measures models were used to compare randomized groups.RESULTS:
Participants' mean age (standard deviation) was 69.6 (5.3); 49.2% were females. Daily supplementation with CE, compared with placebo, had no significant effect on 2-y change in global cognition {mean difference [95% confidence interval (CI)] -0.01 (-0.08, 0.05) standard deviation units (SU)}. CE, compared with placebo, had no significant effects on 2-y change in episodic memory [mean difference (95% CI) -0.01 (-0.13, 0.10) SU] or executive function/attention [mean difference (95% CI) 0.003 (-0.07, 0.08) SU]. Subgroup analyses uncorrected for multiple-testing suggested cognitive benefits of CE supplementation, compared with placebo among those with poorer baseline diet quality.CONCLUSIONS:
Among 573 older adults who underwent repeat in-person, detailed neuropsychological assessments over 2 y, daily CE supplementation, compared with placebo, showed no overall benefits for global or domain-specific cognitive function. Possible cognitive benefits of CE among those with poorer diet quality warrant further study. TRIAL REGISTRATION This trial was registered at clinicaltrials.gov with identifier - NCT02422745.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Vitamines
/
Cacaoyer
Limites:
Aged
/
Female
/
Humans
/
Male
Langue:
En
Journal:
Am J Clin Nutr
Année:
2024
Type de document:
Article