The COSMOS-Mind study is a sub-study to a larger parent trial called COSMOS. It investigated the effects of cocoa extract and a standard multivitamin-mineral on cardiovascular and cancer outcomes in more than 21,000 older participants.

In COSMOS-Mind, researchers tested whether daily intake of cocoa extract vs placebo and a multivitamin-mineral vs placebo improved cognition in older adults.

More than 2200 participants aged 65 and older were enrolled and followed for 3 years. They completed tests over the telephone at baseline and annually to evaluate memory and other cognitive abilities.

Results showed cocoa extract had no effect on global cognition compared with placebo (mean z-score, 0.03; P = .28).

Daily multivitamin use, however, did show significant benefits on global cognition vs placebo (mean z, 0.07, P = .007).

The beneficial effect was most pronounced in participants with a history of cardiovascular disease (no history 0.06 vs history 0.14; P = .01).

Researchers found similar protective effects for memory and executive function.

Older adults who are deficient in essential micronutrients and minerals due to nutrient-deficient diets and who have a high prevalence of cardiovascular disease, diabetes, and other medical comorbidities may benefit from a daily multi-nutrient formulation.

The cocoa extract (Mars Edge, of Mars, Inc.) contained 500 mg of cocoa flavanols, including 80 mg epicatechins and modest amounts of theobromine (∼50 mg/day) and caffeine (∼15 mg/day) that likely enhance flavanols' central and vascular effects.

The multi-nutrient formulation was Centrum Silver (Pfizer Consumer Healthcare, now Haleon).

The COSMOS multi-nutrient formulation contained the following ingredients:


Laura D. Baker, Joann E. Manson, Stephen R. Rapp, Howard D. Sesso, Sarah A. Gaussoin, Sally A. Shumaker, Mark A. Espeland Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial