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Multivitamins May Boost Brain Health in Seniors

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Taking a multivitamin once a day could give you a mental boost as you get older. Based on data from more than 3,500 adults ages 60 and up, researchers from Columbia University and Brigham and Women's Hospital found that a daily nutritional supplement could enhance memory on average by the equivalent of about three years — meaning vitamin-takers had a memory typical of a person three years younger.

After one year, participants using multivitamin supplements performed significantly better on memory tests compared with those taking a placebo "dummy" pill, according to a study published this week in the American Journal of Clinical Nutrition. That benefit was maintained over three years of follow-up.

"Multivitamins basically prevented three years of age-related memory loss," says study co-leader JoAnn Manson, MD, chief of the division of preventive medicine at Brigham and Women's Hospital, and a professor of medicine at Harvard Medical School in Boston. "Multivitamins are a safe, accessible, and affordable approach to protecting cognitive health," Dr. Manson says.

Multivitamins Are No Substitute for Healthy Diet and Exercise

Results from this analysis confirmed an earlier study co-led by Manson linking daily multivitamins to the slowing of cognitive decline. In that research, published last September in Alzheimer's and Dementia, investigators tested more than 2,200 older adults for three years and discovered that daily multivitamin use was associated with a 60 percent slowing of cognitive aging compared with placebo.

Manson emphasizes, however, that multivitamins are no substitute for a healthy diet and healthy lifestyle factors like regular exercise. She views the multivitamin as having a potentially complementary role — where it can especially help those who have some dietary inadequacies.

"We're not recommending that you just throw multivitamins at a fast food diet full of processed and fried foods," she says. "Our first recommendation is that you should try to improve your diet and not just start popping pills."

Findings Suggest Benefit Regardless of Current Eating Habits

For this analysis, the study authors followed 3,562 older adults who were randomly divided into two groups: one assigned to a daily multivitamin supplement — the study used the Centrum Silver brand — and the other given a daily placebo. The average age was 71, about one-third were men, and just over 93 percent were white.

At the outset, participants' diets were assessed through the Alternative Healthy Eating Index, which grades diet on a scale of 0 to 110. Higher scores represent healthier eating habits. The average score for these research subjects was 43, suggesting that many diets were not meeting ideal nutritional standards, but authors called the average consistent with the general U.S. population.

Because a statistically significant benefit was seen across the entire study population, the results suggest that even those who were eating a healthy diet were getting some benefit from taking multivitamin, according to Manson.

While details on vitamin and micronutrient deficiencies were not measured, scientists collected blood samples from a large percentage of the study population and they plan to look in more depth at the baseline nutritional status and also some baseline biomarkers of inflammation, cholesterol, and blood sugar, among others.

The Centrum vitamin used in the study contains B vitamins as well as vitamins D, C, A, and other nutrients. While research has found low levels of B12 and vitamin D to be associated with cognitive decline, Manson says that the mental benefit could not be attributed to any specific micronutrients at this stage, and many of the essential vitamins and minerals in the multivitamin could be contributing to the findings.

Although Centrum Silver was used in the study, Manson believes any high quality, standard multivitamin is likely to provide these memory and cognitive benefits.

Study authors noted that those who had a prior history of cardiovascular disease (under 5 percent of the study population) did better with the multivitamins in terms of cognitive improvement. As to why this is the case, more extensive investigation is needed, according to the researchers.

How Researchers Measured Memory Gain

Those enrolled in the study completed self-administered, web-based assessments of memory and cognition annually over three years. For example, a test for memory recall required participants to view a list of 20 words and then type in all the words they remembered. For those in the vitamin group, performance improved on average from 7.10 words at study start to 7.81 words at one year — an increase of 0.71 words.

The average in the placebo group was 7.21 at study start, and improved by 0.44 to 7.65 after one year.

This effect of vitamin supplementation on memory was sustained over three years. While the effect was "significant," the authors recognized that it was also small and may not be noticeable to all individuals taking vitamins — adding that "even small effect sizes can result in large health benefits at the population level."

Jeffrey Linder, MD, the chief of general internal medicine at the Northwestern Feinberg School of Medicine, calls the results "intriguing," but he did not find them "practice-changing."

"They found a slight difference in immediate memory recall at year one, but not in years two or three," says Dr. Linder, who was not involved in the research. "I have a hard time telling patients they should take a multivitamin to improve their word recall one year later — by about one-quarter of a word over the placebo group — and then there being no differences in years two and three."

Vitamin takers in this study also performed no better in tests of their longer-term memory, visual memory, or executive function — mental abilities that allow us to plan, focus attention, remember, and juggle multiple tasks.

In a past article published by Northwestern, Linder referred to multivitamins as a "waste of money," and emphasized "the evidence-based practices of eating healthy and exercising."

"I worry that people are substituting a multivitamin in place of a good diet or as an insurance policy against a bad diet," says Linder. "I worry that all the focus on supplements and vitamins distract people from things that really keep us healthy, like exercise and eating a healthy, well-balanced diet with lots of fruits and vegetables."

Data from the National Institutes of Health show that about 4 out of 10 Americans age 60 and older take multivitamins. In 2020, multivitamins and supplements generated an estimated $8 billion in sales in the United States.

Lander adds that for those who follow healthy practices, vitamin deficiencies are rare.

More Data Needed to Determine Multivitamin Benefits for Different Groups

Still, he sees no harm in taking a daily multivitamin and would like to see longer-term randomized controlled trials assessing various measures of cognition reported.

Manson and her colleagues plan to do more extensive research on this topic, investigating if benefits are greater for those with lower nutritional status and lower socioeconomic status, and if younger groups of people experience mental gains from multivitamins.

"We now have two separate trials showing benefits for memory and cognition with the multivitamins compared to placebo," says Manson. "We know that nutrition is important for brain health, and this is such a clear signal of benefit."

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