Cocoa extract and cognition in older adults
What it found
In 2,262 older adults, taking cocoa extract every day for 3 years did not change global cognition.
The same trial found that a daily multivitamin-mineral improved global cognition.
What they found
Studies in people
Cocoa extract and cognition
Cocoa extract had no effect on global cognition over 3 years. The mean change in the global cognition score was 0.03 compared with placebo.
Cocoa extract and memory
Cocoa extract had no effect on episodic memory or executive function. The mean change scores were 0.03 for both.
Multivitamin and cognition
Daily multivitamin-mineral for 3 years improved global cognition compared with placebo. The mean change score was 0.07, and benefits were also seen for memory and executive function.
Multivitamin and heart disease
The multivitamin benefit appeared greater in participants with a history of cardiovascular disease. The mean change score was 0.14 for those with a history and 0.06 for those without.
Combining the supplements
Adding cocoa extract did not change the multivitamin benefit. There was no interaction between the two supplements for any cognitive score.
What the authors conclude
“In conclusion, daily intake of cocoa extract for 3 years had no effect on cognition.”
Also in their conclusions
- They conclude that daily intake of cocoa extract for 3 years had no effect on cognition.
- They state that the trial provides the first evidence from a large-scale, long-term, pragmatic randomised controlled trial to suggest that daily use of a multivitamin-mineral supplement has the potential to improve or protect cognitive function for older women and men.
- They advise that an additional trial is needed to confirm these findings in a more representative cohort and to explore potential mechanisms for cognitive benefit.
How it was done
The authors wanted to find ways to protect thinking and memory in older adults, since dementia affects more than 46 million people worldwide. They note that evidence for cocoa flavanols and for multivitamins has been mixed, and that no treatment has been shown to prevent cognitive decline in older adults without symptoms.
They ran a randomised trial called COSMOS-Mind with 2,262 people aged 65 and over (mean age 73; 60% women). Participants took cocoa extract containing 500 mg of cocoa flavanols, a multivitamin-mineral, both, or placebo every day for 3 years, and did telephone cognitive tests at the start and each year.
What it can’t tell you
- The trial cannot show whether cocoa extract might affect cognition over a longer period or at higher doses than the 500 mg of cocoa flavanols tested here.
- It cannot show whether the results apply to younger people or to groups that were not well represented in the study.
Who paid
- Funding
- Funded by NIA NIH HHS (from the PubMed record).
- Conflicts
- Competing Interests. Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health and the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Neither the National Institutes on Health, Mars, nor Pfizer contributed to any aspect of the trial including design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. The authors have no competing interests to report. Declarations of Interest: None
- Authors work at
- Wake Forest University School of Medicine, USA; Brigham and Women's Hospital, USA; Harvard T.H. Chan School of Public Health, USA
The paper
- Title
- Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial
- Type
- Randomised controlled trial
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Baker LD, Manson JE, Rapp SR, et al (2023). Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Alzheimer's & dementia. doi:10.1002/alz.12767Free full textPubMed 36102337DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error