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Daily multivitamin may slow cognitive decline in older adults, study shows

Healthcare Sep 18, 2022 at 08:37

Daily multivitamin may slow cognitive decline in older adults, study shows

Some degree of age-related cognitive decline is common, but older adults are also at risk for developing cognitive disorders like Alzheimer’s disease and other forms of dementia.
Research is ongoing about the factors that influence cognitive health and what may help prevent or slow cognitive decline.
A new study found that multivitamin-mineral supplements improved memory, executive function, and cognition among older adults who took a daily dose.

Older adults experiencing cognitive decline are at risk for Alzheimer’s disease (AD) and other forms of dementia.

Experts are still working to understand what factors influence cognitive function and what measures people can take to help prevent cognitive decline.

A​ study published in Alzheimer’s & DementiaTrusted Source examined whether or not taking a daily multivitamin or cocoa extract affected cognitive function in older adults.

While authors didn’t see improvements related to taking cocoa, they did find that taking a daily multivitamin-mineral supplement was associated with improved memory and executive function.

Cognitive decline in the older adults

Many people experience some level of age-related cognitive declineTrusted Source as they get older. For example, occasionally forgetting details or misplacing something can happen more with age.

But severe cognitive decline may lead to Alzheimer’s disease and dementia, which involves significant changes in a person’s ability to remember or make judgments and impacts their everyday life.

W​hile diseases like Alzheimer’s and other forms of dementiaTrusted Source are not a usual part of getting older, people over the age of 65 are more at risk of developing these conditions.

Dr. Austin Perlmutter, an internal medicine physician, author, a senior director of Science and Clinical Innovation at Big Bold Health, not involved in the study, explained to MNT:

“Researchers tend to agree that on the whole, aging is linked to alterations in cognitive function. What is arguably the most commonly discussed change in brain function associated with aging is a decline in long-term memory, where a general worsening of memory has sometimes been called part of ‘normal aging.’

More significant worsening is tethered to dementias like Alzheimer’s disease. There’s also work suggesting a general decline in working memory (a temporary storage system in our brains that lets us work with multiple bits of information) in the elderly as well as relatively more trouble with multitasking.”

Experts are still working to understand the full impact of changes related to age. Research is also focused on what preventive steps older adults can take to improve and maintain cognitive function.

Multivitamin and cognitive decline

For the study, researchers looked at how taking daily cocoa extract or a daily multivitamin-mineral (MVM) supplement impacted cognitive function compared to a placebo.

The authors of this study performed a randomized clinical trial that included over 2,000 adults ages 65 and older.

Participants had to meet specific eligibility criteria to be in the study. For example, they had to have no history of heart attacks or have a serious illness that would prevent them from participating. They also couldn’t have allergies to cocoa products or caffeine.

Researchers set up a baseline for participants’ cognitive function at the beginning of the study.

They also looked at participants’ ability to recall events and memories (episodic memory) and their executive functionTrusted Source, which has to do with focus and thinking. They reassessed these components annually for 3 years.

Results from the study show that cocoa extract did not affect cognition. However, multivitamin use was associated with improved cognition, executive function, and episodic memory. Participants with cardiovascular disease saw the greatest benefit.

Study author Laura D. Baker, Ph.D., professor of gerontology and geriatric medicine at Wake Forest University School of Medicine in Winston-Salem, NC, explained to MNT:

“Daily supplementation with a multivitamin shows potential of improving (or protecting) cognitive abilities in older adults. More work is needed before a widespread recommendation can be made, however. Daily supplementation with a multivitamin showed a relatively stronger benefit for adults with cardiovascular disease. Since only 10% of our sample (~200 people) reported significant cardiovascular events (e.g., stent, congestive heart failure, angioplasty) at the time they entered the study, this finding needs to be replicated in a larger sample that includes more individuals with significant cardiovascular disease.”

Dr. Perlmutter also offered his thoughts:

“The positive correlation between the multivitamin consumption and cognition versus placebo is notable, and while the overall data on multivitamins has been less supportive of a clear net benefit in the general population, it does provide some support for the idea that ensuring adequate levels of key micronutrients may be helpful for longer-term brain health in aging populations, especially those with pre-existing vascular disease.”

L​imitations and areas for future research

Overall, the study findings indicate that taking a daily multivitamin is associated with improved cognitive function among older adults. However, the study had some limitations.

For instance, the data relied on self-reporting from participants, which can increase the risk of errors in data collection. Representation of certain races or ethnicities did not reflect the older American population. Therefore, the study’s results cannot be generalized, and future studies will need to account for diversity.

In addition, researchers were also unable to link cocoa to the cognitive benefits they observed. They also note that more research is needed to confirm the cognitive benefits of the multivitamin. Other limitations were related to specific data analyses.

D​r. Baker noted the following areas for continued research to MNT:

“These results point to a new avenue of investigation that will hopefully identify a highly accessible, inexpensive, and safe intervention to provide a layer of protection against cognitive decline for older adults. The results need to be replicated in a larger group that is more representative of the U.S. demographics (e.g., only 11% of our cohort represented communities of color). We need to understand the mechanisms that might account for the observed multivitamin cognitive benefit.”

Nevertheless, the study offers encouragement that even simple changes can help to improve health without many risks of side effects. As research progresses, recommendations for improving cognitive health will hopefully become more evident.

Today, an estimated 5.8 millionTrusted Source people aged 65 years or older in the United States have dementia.

Due to the fact that the average lifespan of people in the U.S. has increased over recent decades, some experts project that by 2050, the number of older adults with dementia could reach 13.8 millionTrusted Source.

Figures of this stature spark justifiable fear, and, as we have found in previous Medical Myths articles, fear tends to breed misconceptions.

In this article, we aim to dispel 11 of these myths.

1. Dementia is inevitable with age

This statement is not true. Dementia is not a normal part of aging.

According to a report that the Alzheimer’s Association published, Alzheimer’s disease, which is the most common form of dementia, affects 3% of people aged 65–74 years in the U.S.

As a result of the risk increasing as we age, 17% of people aged 75–84 years and 32% of people aged 85 years and older have a dementia diagnosis.

2. Dementia and Alzheimer’s disease are the same thing

This is not quite correct. Alzheimer’s is a type of dementia, accounting for 60–80% of all dementia cases. Other types of dementia include frontotemporal dementia (FTD), vascular dementia, mixed dementia, and Lewy body dementia.

The National Institute on AgingTrusted Source define dementia as “the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.”

Although dementias share certain characteristics, each type has a distinct underlying pathology.

Alzheimer’s disease is associated with a buildup of so-called plaques and tangles in the brain. These structures interfere with brain cells, eventually killing them. In contrast, brain cell death in vascular dementia occurs due to a lack of oxygen, which can result from a stroke, for instance.

FTD, as another example, occurs when abnormal protein structures form in the frontal and temporal lobes of the brain, causing the brain cells in these regions to die.

3. A family member has dementia, so I will get it

A common myth is that dementia is purely genetic. In other words, if a person’s family member has a dementia diagnosis, they are guaranteed to develop dementia later in life. This is not true.

Although there is a genetic component to some forms of dementia, the majority of cases do not have a strong genetic link.

As we learned above, rather than genetic factors, the most significant risk factor for dementia is age. However, if a parent or grandparent developed Alzheimer’s when they were younger than 65 years, the chance of it passing on genetically is higher.

Early-onset Alzheimer’s is relatively uncommon, though. It occurs in about 5.5%Trusted Source of all Alzheimer’s cases.

As the majority of dementia cases are Alzheimer’s disease, this means that most dementia cases are not hereditary. FTD, which is much less common, has a stronger genetic link, but if a parent or grandparent develops the condition, it does not mean that children or grandchildren are guaranteed to develop it.

Today, FTD affects an estimated 15–22 in every 100,000Trusted Source people. Of these individuals, 10–15% have a strong family history of the condition.

4. Dementia only affects older adults

Age is a risk factor for dementia, but dementia can affect younger adults in rare cases. Some scientists estimateTrusted Source that, in people aged 30–64 years, 38–260 people in 100,000 — equivalent to 0.038–0.26% — develop early-onset dementia.

In the 55–64 age bracket, this increases to close to 420 people in 100,000, or 0.4%.

5. Using aluminum pans causes Alzheimer’s

In the 1960s, scientists injected rabbits with high levels of aluminum. They found that the animals developed neurological lesions similar to those that form in the brains of people with Alzheimer’s.

Additionally, some studiesTrusted Source have identified aluminum within the plaques associated with Alzheimer’s. However, aluminum also appears in the healthy brain, and researchers have not established a causal link between this element and the disease.

Following on from these studies, myths still circulate that drinking from aluminum cans or cooking with aluminum pots increases the risk of Alzheimer’s.

However, since those early experiments, scientists have not found a clear association between Alzheimer’s and using aluminum pots and pans.

Although researchers will, eventually, establish the precise relationship between aluminum and Alzheimer’s, consuming aluminum through the diet is unlikely to play a major role.

As the Alzheimer’s Society explain: “Aluminum in food and drink is in a form that is not easily absorbed into the body. Hence, the amount taken up is less than 1% of the amount present in food and drink. Most of the aluminum taken into the body is cleaned out by the kidneys.”

However, they also write that some research has found “a potential role for high dose aluminum in drinking water in progressing Alzheimer’s disease for people who already have the disease.”

6. Dementia signals the end of a meaningful life

Thankfully, this is not the case. Many people with a dementia diagnosis lead active, meaningful lives. Some people fear that if a doctor diagnoses them with dementia, they will no longer be able to go for a walk alone and will have to stop driving their vehicle immediately.

It is true that these adjustments may come in time as the condition progresses, but in mild cases of dementia, no changesTrusted Source may be necessary. As dementia worsens, changes to the way an individual leads their life are likely, but that does not mean that the person cannot lead a fulfilling life.

“Too many people are in the dark about dementia — many feel that a dementia diagnosis means someone is immediately incapable of living a normal life, while myths and misunderstandings continue to contribute to the stigma and isolation that many people will feel,” explains Jeremy Hughes, former Chief Executive of the Alzheimer’s Society.

“[W]e want to reassure people that life doesn’t end when dementia begins.”

– Jeremy Hughes

7. Memory loss always signifies dementia

Although memory loss can be an early symptom of dementia, it does not necessarily signify the start of this condition. Human memory can be unpredictable, and we all forget things occasionally. However, if memory loss is interfering with everyday life, it is best to speak with a doctor.

Although memory issues tend to be an early signTrusted Source of Alzheimer’s disease, that is not the case for other forms of dementia. For instance, early signs and symptoms of FTD can include changes in mood and personality, language difficulties, and obsessive behavior.

8. Dementia is always preventable

This, unfortunately, is untrue. Importantly, though, certain factors can either reduce the risk of certain types of dementia developing or delay their onset.

For instance, the Lancet Commission’s 2020 reportTrusted Source on dementia prevention, intervention, and care lists 12 factors that increase the risk of dementia:

less education
hypertension
hearing impairment
smoking
obesity
depression
physical inactivity
diabetes
low levels of social contact
alcohol consumption
traumatic brain injury
air pollution

Some of these factors are more difficult to modify than others, but working on changing any of them might help reduce the risk of developing dementia. The authors of the report explain:

However, as Dr. Nancy Sicotte, a neurologist at Cedars-Sinai hospital in Los Angeles, CA, explains, “Reducing your risk requires starting these lifestyle changes from the get-go, not waiting until you’re 70.”

9. Vitamins and supplements can prevent dementia

Linked to the section above, this is also false. To date, there is no strong evidence that any vitamin or mineral supplements can reduce the risk of dementia. In 2018, the Cochrane Library conducted a review with the aim of answering this question.

Their analysis included data from more than 83,000 participants across the 28 included studies. Although the authors report “some general limitations of the evidence,” they conclude:

“We did not find evidence that any vitamin or mineral supplementation strategy for cognitively healthy adults in mid or late life has a meaningful effect on cognitive decline or dementia, although the evidence does not permit definitive conclusions.”

10. All people with dementia become aggressive

In some cases, people with dementia might find it increasingly hard to make sense of the world around them. This confusion can be frustrating, and some individuals might respond to the emotions in an angry manner. However, this is not the case for everyone.

In a study involving 215 people with dementia, 41% of the participants developed aggression during the 2-year study. When they looked at factors that increased the risk of developing aggression, the researchers identified two of the primary factors as physical pain and a low quality relationship between the person and their caregiver.

11. Dementia is never fatal

Unfortunately, dementia can be fatal. According to a 2020 studyTrusted Source among adults aged 70-99 years, dementia may be a more common cause of death than experts have traditionally thought. The authors “found that approximately 13.6% of deaths were attributable to dementia over the period 2000–2009.”

Dementia worries people, especially as they age, and this is justifiable in many ways. However, it is important to counter misinformation that might enhance concerns and stigma.

For now, researchers are working tirelessly to develop better ways to treat and prevent dementia. In the future, hopefully, science will reduce the impact of dementia and, therefore, the fear associated with the condition.