In a recent study published in The American Journal of Clinical Nutrition, researchers investigated whether regular coffee extract (CE) supplementation could improve cognitive performance over a two-year period.

The fastest-growing age segment within the US is adults aged ≥65 years who’re at high risk for developing Alzheimer’s disease and related dementias (ADRDs). A decrease in cognitive function during aging could increase ADRD risk. Interventions targeting the earliest signs of age-related cognitive decline may help preserve cognitive function. Previous randomized clinical trials have shown promising findings in regards to the effects of cocoa extract on late-life cognition. An extended-term RCT using offline neuropsychological tests may make clear CE’s cognitive effects.

Study: Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial. Image Credit: Neirfy / Shutterstock

In regards to the study

In the current study, researchers evaluated the impact of standard coffee extract supplementation on cognition over two years in 573 older individuals from the clinical subgroup of the COCOa Complement and Multivitamin Outcomes Study (COSMOS trial, subgroup COSMOS-Clinic) and underwent offline, detailed neuropsychological tests.

The COSMOS trial is a 2×2 factorial randomized controlled trial examining the impact of a every day coffee extract [comprising 500 mg flavanols and 80 mg (–)-epicatechin) and a multivitamin-mineral complement (MVM) on heart problems and cancer prevention amongst 21,442 US adults aged 60. The study included 573 participants within the clinic sub-cohort, with 492 completing two-year follow-up assessments.

The trial excluded individuals with a history of stroke, myocardial infarction, cancer, or other serious diseases, unwillingness to discontinue multivitamins, vitamin D, and CE supplementations in the course of the trial, extreme caffeine sensitivity, lower than 75% adherence to check medications over ≥2.0 months of placebo run, and people who couldn’t speak English.

The current study included 603 individuals from the COSMOS-Clinic who resided in greater Boston to undergo health assessments and specimen collection at study initiation and two years. The study included individuals without significant hearing impairment who finished a 45-minute neuropsychological evaluation battery.

The first end result was the worldwide cognition composite, averaging z-scores of 11 tests: 3MS; Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) total learning, delayed recall, and recognition; instantaneous and delayed East Boston Memory Test (EBMT) recall trials; two assessments of categorical fluency (naming vegetables and animals, Trail Making Test (TMT) Parts A and B; and the Digit Span Backward assessment.

The secondary study outcomes included composite measures of episodic memory (z-scores from 4 assessments: EBMT and CERAD instantaneous and delayed recalls; and executive/attention function composite measure (z-scores from five tests: two categorical fluency, Digit Span Backwards test, TMT-Part A, and TMT-Part B).

The team explored potential modifying roles of baseline aspects, including weight-reduction plan and flavanol status, on the results of coffee extract and placebo on cognition. The researchers stratified the first analyses by habitual weight-reduction plan quality or habitual flavanol consumption. Within the subgroup analyses, the team addressed whether design variables and subgroups chosen a priori in line with their relevance in cognitive decay and Alzheimer’s disease and related dementia risk modified the results of CE, in comparison with placebo, on global cognition over two years.

Within the post-hoc evaluation, the team reran the first analyses evaluating the results of treatment on domain-specific and global cognitive scores after adjusting for extra potential confounding variables significantly differing between the study groups.

Results

The mean participant age was 70 years; 49% were female; 54% had received postbaccalaureate education, and 11% reported pre-randomization every day chocolate consumption. Of the 603 participants, 573 accomplished all baseline cognitive evaluations, and 14% were lost to follow-up. Among the many participants, 285 and 288 comprised the CE and placebo groups, respectively. At one yr, 98% of coffee extract and 96% of placebo recipients complied with the interventions, while at two years, 91% of each groups exhibited satisfactory adherence.

The study showed no significant effects of coffee extract supplementation on two-year changes in global cognition, episodic memory, or executive function/attention. Nevertheless, subgroup analyses indicated the cognitive advantages of coffee extract supplementation amongst those with poorer baseline weight-reduction plan quality. Nevertheless, there have been no significant interactions between coffee extract supplementation and habitual flavanol consumption. Post hoc analyses showed no significant effect of coffee extract supplementation on cognitive function scores.

Overall, the study findings showed that every day cocoa extract supplementation didn’t significantly improve global or domain-specific cognitive function in comparison with a placebo over two years. Nevertheless, a subgroup evaluation showed suggestive advantages for cognitive function amongst those with poorer habitual weight-reduction plan quality at baseline. Further research is required to elucidate the e role of CE supplementation in additional diverse populations and people with lower weight-reduction plan quality. The current study findings align with the first results of two COSMOS cognitive ancillary randomized controlled trials, i.e., COSMOS-Web and COSMOS-Mind.