Does daily administration of cocoa extract (500 mg/day flavanols) or a commercial multivitamin-mineral (MVM) improve cognition in older women and men?
Cocoa Flavanol Extract, a randomized trial in 2262 participants (Alzheimers Dement 2022, PMID 36102337) — cocoa extract had no effect on global cognition (mean z-score = 0.03, 95% CI: -0.02 to 0.08; P =.28). The interaction between cocoa extract and MVM was not significant.
Source: Alzheimers Dement 2022, PMID 36102337 ↗ · Research map · How Magellan grades evidence · evidence confidence: high
Alzheimers Dement · 2022 · PMID 36102337 · DOI 10.1002/alz.12767
Daily multivitamin-mineral supplementation, but not cocoa extract, improved global cognition, memory, and executive function in older adults over three years.
The question
Does daily administration of cocoa extract (500 mg/day flavanols) or a commercial multivitamin-mineral (MVM) improve cognition in older women and men?
What they tested
The study implicitly hypothesized that either cocoa extract or a multivitamin-mineral supplement would improve cognition in older adults.
How they did it
COSMOS-Mind was a 3-year randomized two-by-two factorial trial involving 2262 participants (mean age 73 years; 60% women; 89% non-Hispanic White). Cognition was assessed annually by telephone using a global cognition composite score derived from multiple tests. The primary outcome was the change in this composite with 3 years of cocoa extract use, and a pre-specified secondary outcome was the change with 3 years of MVM supplementation. Treatment effects were also examined for executive function and memory, and in pre-specified subgroups.
What they found
Cocoa extract had no effect on global cognition (mean z-score = 0.03, 95% CI: -0.02 to 0.08; P = .28). Daily MVM supplementation resulted in a statistically significant benefit on global cognition (mean z = 0.07, 95% CI 0.02 to 0.12; P = .007). This MVM effect was more pronounced in participants with a history of cardiovascular disease (no history: 0.06, 95% CI 0.01 to 0.11; history: 0.14, 95% CI -0.02 to 0.31; interaction, nominal P = .01). MVM benefits were also observed for memory and executive function. The interaction between cocoa extract and MVM was not significant.
| Cocoa Extract | 0.03 | |
|---|---|---|
| Multivitamin-Mineral | 0.07 |
Mean z-score change in global cognition after 3 years of supplementation with cocoa extract or multivitamin-mineral.
What it means
Cocoa extract did not benefit cognition in older adults. However, daily multivitamin-mineral supplementation for 3 years improved global cognition, episodic memory, and executive function in older adults, with a potentially greater benefit for those with cardiovascular disease.
Limitations
Additional work is needed to confirm these findings in a more diverse cohort and to identify mechanisms for the MVM effects. The study population was predominantly non-Hispanic White.
The paper at a glance
| Magellan’s evidence label | vascular flavanols, cognition (our label for this citation — see PubMed for the paper’s own title and authors) |
|---|---|
| Journal | Alzheimers Dement |
| Year | 2022 |
| PMID | 36102337 ↗ |
| DOI | 10.1002/alz.12767 ↗ |
| Topic | Brain, cognition & mood |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
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Cocoa Flavanol Extract
In the large COSMOS randomized trial of older adults, daily cocoa extract did not significantly reduce the primary composite of total cardiovascular events, though cardiovascular death was 27% lower in secondary analyses and an ancillary analysis found the inflammatory marker hsCRP rose about 8% per year more slowly;
Cocoa flavanols are a class of bioactive polyphenols—chiefly the monomer (-)-epicatechin and its…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). Does daily administration of cocoa extract (500 mg/day flavanols) or a commercial multivitamin-mineral (MVM) improve cognition in older women and men? [Plain-English summary of Alzheimers Dement 2022, PMID 36102337, DOI 10.1002/alz.12767]. Magellan Longevity. https://magellanlongevity.com/study/s116.html@misc{magellan_s116,
title = {Does daily administration of cocoa extract (500 mg/day flavanols) or a commercial multivitamin-mineral (MVM) improve cognition in older women and men?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/s116.html}},
note = {Plain-English summary of PubMed PMID 36102337; DOI 10.1002/alz.12767; Alzheimers Dement 2022. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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