Cochrane for Clinicians
Putting Evidence into Practice
Vitamin and Mineral Supplementation for Maintaining Cognitive Functioning in Cognitively Healthy Adults
Am Fam Physician. 2020 Mar 1;101(5):272-273.
Author disclosure: No relevant financial affiliations.
Are vitamin and mineral supplements beneficial in preserving cognitive functioning or preventing cognitive decline in cognitively healthy adults 40 years and older?
Vitamin and mineral supplementation has little to no beneficial effect on preserving cognitive functioning or preventing dementia in cognitively healthy adults 40 years and older.1 (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)
In 2010, an estimated 35 million people worldwide had dementia, and the prevalence is expected to double by 2030. Modifiable risk factors for dementia include diabetes mellitus, midlife obesity and hypertension, smoking, and physical inactivity. Vitamins and minerals have recognized roles in normal functioning and development, so it has been hypothesized that dietary supplementation may prevent dementia. This Cochrane review sought to evaluate whether vitamin and mineral supplementation preserves cognitive functioning or prevents decline in cognitively healthy adults 40 years and older.1
The Cochrane authors identified 28 randomized controlled trials involving more than 83,000 cognitively healthy participants 40 years and older. These trials compared oral vitamin and mineral supplements with either placebo or usual care for at least 12 weeks. The primary outcome was overall cognitive functioning as measured by various accepted and validated scales. Secondary outcomes included subdomain measures (i.e., episodic memory, executive functioning, and cognitive processing speed), incidence of mild cognitive impairment (MCI) or dementia, serious adverse events, and mortality. Most studies did not assess the incidence of dementia specifically or reflect performance of a baseline cognitive assessment. Ten studies had follow-up from five to 10 years, and only one study had follow-up longer than 10 years. The authors pooled study data into five supplement groups based on their theorized m
Referencesshow all references
1. Rutjes AW, Denton DA, Di Nisio M, et al. Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life. Cochrane Database Syst Rev. 2018;(12):CD011906....
2. Brandt J, Spencer M, Folstein MF. The telephone interview for cognitive status. Neuropsychiatry Neuropsychology Behavioral Neurology. 1988;1(2):111–117.
3. Kang JH, Cook NR, Manson JE, et al. Vitamin E, vitamin C, beta carotene, and cognitive function among women with or at risk of cardiovascular disease: the Women's Antioxidant and Cardiovascular Study. Circulation. 2009;119(21):2772–2780.
4. Lippman SM, Klein EA, Goodman PJ, et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the selenium and vitamin E cancer prevention trial (SELECT). JAMA. 2009;301(1):39–51.
5. Petersen RC, Lopez O, Armstrong MJ, et al. Practice guideline update summary: mild cognitive impairment: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2018;90(3):126–135.
This series is coordinated by Corey D. Fogleman, MD, assistant medical editor.
A collection of Cochrane for Clinicians published in AFP is available at https://www.aafp.org/afp/cochrane.
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