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Effects of multivitamin, mineral and herbal supplement on cognition in younger adults and the contribution of B group vitamins
Abstract
Cognitive benefits of multivitamins have been observed in the elderly, but fewer trials have investigated younger, healthy cohorts. This randomised, double-blind, placebo-controlled study investigated the cognitive effects of 16-week multivitamin supplementation in adults aged 20-49 years.
A total of 138 participants aged 20-50 years were randomised and 116 completed the trial. The participants completed a computerised battery of cognitive tasks before and after 16-week supplementation with a multivitamin containing minerals and herbs or placebo. Blood measures of homocysteine, vitamin B6, B12 and folate were collected at both time points.
In men, there was a strong trend (p = 0.01; which did not reach significance when adjusted for multiple comparisons) for the multivitamin to improve performance on the incongruent stroop task, a measure of selective attention and response inhibition. There were no cognitive benefits of multivitamin supplements in women. Multivitamin supplementation substantially increased blood levels of vitamin B6, B12 and folate in both genders and decreased homocysteine in men. In men who received the multivitamin, improved stroop congruent performance was associated with increased vitamin B6 levels.
Multivitamin supplementation may be useful for maintaining levels of B vitamins. The effects of multivitamins on speeded attention such as the stroop task in young adults warrant further investigation. Copyright © 2014 John Wiley & Sons, Ltd.
... In addition to improvements in memory, two trials found improvements in mood following only four weeks of multinutrient supplementation [17,18] A recent meta-analysis further supports the benefit of B vitamins on cognitive function, demonstrating improvements in episodic memory [19]. In healthy adults aged 20-50, multivitamin supplementation over 16 weeks was associated with a trend towards improvement in performance on the incongruent Stroop task, but this effect was only evident in men [20]. In addition, Haskell and colleagues [21] found significant improvements in speed of completing the Stroop task in females aged 25 to 50 years following nine weeks supplementation with a multinutrient containing B vitamins. ...
... The primary outcomes were performance (accuracy % divided by speed of response in milliseconds) on memory (spatial working memory task from SUCCAB) and attention (incongruent version of the Stroop colour-word task from SUCCAB). Previous studies of multinutrient supplementation, with comparable doses of B vitamins, Ginkgo biloba, and Bacopa monnieri, to the current supplement under investigation have found medium sized effects (eta squared = 0.09, Cohens d = 0.63) for short term memory [15] and a trend for significance (eta squared = 0.08) on the incongruent Stroop task in men [20]. Power analysis was conducted using G*Power 3.1.9.2 [54]. ...
... Allowing for 80% power, 2.5% significance and an effect of this magnitude (f = 0.29), in a two armed study (active supplementation, placebo) with two assessments (baseline, final), a total sample of 116 was required The primary outcomes were performance (accuracy % divided by speed of response in milliseconds) on memory (spatial working memory task from SUCCAB) and attention (incongruent version of the Stroop colour-word task from SUCCAB). Previous studies of multinutrient supplementation, with comparable doses of B vitamins, Ginkgo biloba, and Bacopa monnieri, to the current supplement under investigation have found medium sized effects (eta squared = 0.09, Cohens d = 0.63) for short term memory [15] and a trend for significance (eta squared = 0.08) on the incongruent Stroop task in men [20]. Power analysis was conducted using G*Power 3.1.9.2 [54]. ...
Citation: Young, L.M.; Gauci, S.; Arnoldy, L.; Martin, L.; Perry, N.; White, D.J.; Meyer, D.; Lassemillante, A.-C.; Ogden, E.; Silber, B.; et al.
... We present the results according to population groups. To display a meaningful synthesis of our results, we categorized the populations from the studies into four population groups: healthy individuals [39][40][41][42][43][44][45][46], those with vitamin B deficiency [47,48], those with elevated homocysteine levels [49][50][51], and those with other risk factors for cognitive decline [52][53][54][55][56][57][58] (see Table 4). This categorization can be justified by taking into consideration the fact that each of the groups (except "healthy individuals") represents a risk factor for developing cognitive impairment. ...
... Three studies included middle-aged to elderly individuals (i.e., 45-80 years, > 40 years, and 50-70 years) [49,52,56]. Four studies also included young adults (i.e., 20-49 years, 18-86 years, 20-92 years, and over the age of 21 years) [39,40,44,53]. One trial did not set any age-related restrictions [55]. ...
... While most studies included both male and female participants, 3 studies included only women [39,46,56] and one study assessed only men [54]. Four trials investigated the effects of a multivitamin formula on cognitive function but explicitly included vitamin B in their analysis and were therefore included [40,41,44,46]. The characteristics of the studies and interventions are presented in Table 3. ...
Zusammenfassung Hintergrund und Ziele Die Entwicklung kognitiver Beeinträchtigungen ist eine bedeutsame, durch die steigende Lebenserwartung und Qualität der Gesundheitsversorgung noch an Relevanz zunehmende Thematik unserer heutigen Gesellschaft. Ein potenzieller Ansatz kognitive Funktionseinbußen zu verhindern, liegt in der Verwendung von Vitamin B zur Reduktion von Homocystein im menschlichen Körper. In dieser systematischen Übersichtsarbeit und Meta-Analyse wurde dieser Ansatz verfolgt und untersucht, ob die orale Nahrungsergänzung mit Vitamin B kognitive Beeinträchtigungen bei vorher unauffälligen Probanden erfolgreich verhindern kann. Methoden Zur Untersuchung dieser Fragestellung wurde eine systematische Literaturrecherche durchgeführt. Hierfür wurden die elektronischen Datenbanken PubMed, Embase und Cochrane Library durchsucht. Als Einschlusskriterien wurden die orale Nahrungsergänzung mit Vitamin B (B1, B6, Folsäure und B12) und das Fehlen kognitiver Beeinträchtigungen festgelegt. Es wurde eine Meta-Analyse mit Veränderungen der „Globalen Kognition“ als primärem Endpunkt dieser Arbeit durchgeführt. Als sekundäre Endpunkte wurden Veränderungen der kognitiven Funktion in weiteren in den Studien berichteten kognitiven Domänen festgelegt. Das Verzerrungsrisiko auf Studien-Ebene und auf Endpunkt-Ebene wurde mithilfe des Cochrane Risk of Bias Tools und des GRADE Ansatzes beurteilt. Hiermit wurde die Aussagekraft der Gesamtevidenz eingeschätzt und bewertet. Ergebnisse und Beobachtungen Die Meta-Analyse zeigte keinen signifikanten Effekt der oralen Nahrungsergänzung mit Vitamin B auf die kognitive Funktion. Eine Sensitivitätsanalyse mit Fokus auf spezielle Risikofaktoren beeinflusste dieses Ergebnis nicht. Einige der eingeschlossenen Studien berichteten zwar über isolierte signifikante Effekte der Intervention auf einzelne sekundäre Endpunkte. Jedoch überwog die Zahl der kognitiven Tests ohne berichteten signifikanten Effekt. Schlussfolgerungen Insgesamt zeigte sich kein Anhalt dafür, dass die orale Nahrungsergänzung mit Vitamin B kognitive Beeinträchtigungen verhindern könnte. Die berichteten isolierten signifikanten Effekte könnten Zeichen methodischer Probleme sein. Die Ergebnisse dieser Übersichtsarbeit zeigten keinen Hinweis darauf, dass bestimmte Risikogruppen einen höheren Benefit aus der Intervention ziehen könnten. Diese Arbeit lässt keine Schlussfolgerungen auf den Effekt anderer Applikationsformen als der oralen Aufnahme zu. Des Weiteren kann keine Aussage über den Effekt der Intervention auf kognitiv bereits beeinträchtigte Personen getroffen werden. Offenlegung (Teil-)Ergebnisse der vorliegenden Arbeit wurden veröffentlicht in: - Optimierungsstrategien bei Demenz – Forschung zu Prävention, Therapie und Versorgung, Gräßel et al., 2018 [1]. - Vitamin B – Can it prevent cognitive decline? A systematic review and meta-analysis, Behrens et al, 2020 [2]. (Teil-)Ergebnisse der vorliegenden Arbeit wurden auf folgenden Konferenzen vorgestellt: - Mehrmalige Kolloquien im Rahmen des strukturierten Graduiertenkollegs „OptiDem – Optimierungsstrategien bei Demenz“ 2016-2018 in Erlangen, Essen, Potsdam und Tübingen - Abschlusstagung des strukturierten Graduiertenkollegs „OptiDem – Optimierungsstrategien bei Demenz“ der Karl und Veronica Carstens-Stiftung am 18.09.2018 in Essen - XIV. Kongress der Deutschen Gesellschaft für Gerontopsychiatrie und –psychotherapie e.V. (DGGPP) am 17.05.2019 in Essen
... We present the results according to population groups. To display a meaningful synthesis of our results, we categorized the populations from the studies into four population groups: healthy individuals [39][40][41][42][43][44][45][46], those with vitamin B deficiency [47,48], those with elevated homocysteine levels [49][50][51], and those with other risk factors for cognitive decline [52][53][54][55][56][57][58] (see Table 4). This categorization can be justified by taking into consideration the fact that each of the groups (except "healthy individuals") represents a risk factor for developing cognitive impairment. ...
... Three studies included middle-aged to elderly individuals (i.e., 45-80 years, > 40 years, and 50-70 years) [49,52,56]. Four studies also included young adults (i.e., 20-49 years, 18-86 years, 20-92 years, and over the age of 21 years) [39,40,44,53]. One trial did not set any age-related restrictions [55]. ...
... While most studies included both male and female participants, 3 studies included only women [39,46,56] and one study assessed only men [54]. Four trials investigated the effects of a multivitamin formula on cognitive function but explicitly included vitamin B in their analysis and were therefore included [40,41,44,46]. The characteristics of the studies and interventions are presented in Table 3. ...
Background:
Development of cognitive decline represents substantial issues in today's society, steadily gaining importance with increasing life expectancy. One potential approach to preventing cognitive decline is to lower homocysteine by administering vitamin B. In this systematic review and meta-analysis, we address this topic and investigate whether oral supplementation of vitamin B can successfully prevent cognitive decline in cognitively unimpaired individuals.
Methods:
A computerized systematic literature search was conducted using the electronic databases PubMed, Embase, and the Cochrane Library. Eligibility criteria included oral supplementation with vitamin B (B1, B6, folic acid, and B12) and the absence of cognitive impairment. A meta-analysis was conducted with "global cognition" as the primary outcome of this review. Secondary outcomes were changes in cognitive function in other cognitive domains reported in the included studies. Risk of bias was assessed according to the Cochrane Risk of Bias tool and the GRADE approach to establish the overall certainty of the evidence.
Results:
The meta-analysis did not yield a significant overall effect of supplementation with vitamin B on cognitive function (Z = 0.87; p = 0.39; SMD, 0.02; 95% CI, - 0.034, 0.08). A sensitivity analysis focusing on specific risk factors did not alter this result. Some studies reported isolated significant effects of the intervention on secondary outcomes. However, these findings were outnumbered by the number of cognitive tests that did not yield significant effects.
Discussion:
We found no overall evidence that oral vitamin B supplementation prevented cognitive decline. The isolated significant effects that were reported could be attributed to methodological issues. The results of this review do not provide evidence that population groups with certain risk factors would profit more from the intervention than others. Our findings do not apply to forms of administration other than oral supplementation nor do they offer information regarding the treatment of cognitively impaired individuals via the administration of vitamin B.
Systematic review registration:
PROSPERO CRD42017071692.
... In contrast, other studies found an association between multivitamin supplementation, faster and more accurate numerical processing in healthy adults (Haskell et al., 2010;Kennedy et al., 2010), improved choice reaction time in children (Haskell et al., 2008), and improved immediate verbal memory and fluency in cognitively healthy older adults (Grima et al., 2012) compared to baseline performance. The picture is far from clear however as contrasting findings have been shown with the same supplement (Swisse Men's Ultivite) in similar cohorts (males between 50 and 74 years), using the same computerized cognitive battery (Pipingas et al., 2010(Pipingas et al., , 2014Harris et al., 2012). Pipingas et al. (2014) found improvement from baseline in selective attention and response inhibition that trended toward significance following 16 weeks of supplementation, whereas Harris et al. (2012) found significant improvements from baseline in recognition memory after 8 weeks of supplementation. ...
... The picture is far from clear however as contrasting findings have been shown with the same supplement (Swisse Men's Ultivite) in similar cohorts (males between 50 and 74 years), using the same computerized cognitive battery (Pipingas et al., 2010(Pipingas et al., , 2014Harris et al., 2012). Pipingas et al. (2014) found improvement from baseline in selective attention and response inhibition that trended toward significance following 16 weeks of supplementation, whereas Harris et al. (2012) found significant improvements from baseline in recognition memory after 8 weeks of supplementation. Despite the differences in length of supplement period both studies found significant change in blood plasma levels of B 6 , B 12 , folate and homocysteine (Harris et al., 2012;Pipingas et al., 2014) indicating that changes in blood levels and cognitive function can be seen over a relatively short 8 week period of supplementation. ...
... Pipingas et al. (2014) found improvement from baseline in selective attention and response inhibition that trended toward significance following 16 weeks of supplementation, whereas Harris et al. (2012) found significant improvements from baseline in recognition memory after 8 weeks of supplementation. Despite the differences in length of supplement period both studies found significant change in blood plasma levels of B 6 , B 12 , folate and homocysteine (Harris et al., 2012;Pipingas et al., 2014) indicating that changes in blood levels and cognitive function can be seen over a relatively short 8 week period of supplementation. These findings are encouraging because they indicate that even brief nutritional enhancement can significantly elevate circulating micronutrient levels, presumably with beneficial effects for health, although it is less clear why different elements of cognition were altered in the different studies. ...
The impact of poor nutrition on physiological health is well understood (Costarelli et al., 2013). Less is known about the effects of diet on brain function and cognition in the general population (Ames, 2010; Parletta et al., 2013; White et al., 2017) and we are still in the early stages of understanding the role of specific nutrients to normal and pathological neuronal functioning. In the present study, the putative effect of a multivitamin/mineral or vitamin D supplement on cognitive function over an 8-week period was compared with volunteers taking vitamin C. Healthy adults (N = 60) were recruited, age range 21–59 years (x¯ = 39.07 years, SD = 11.46), with participants randomly allocated to conditions in a double-blind protocol. Participants also completed a 14-day food diary to gather information on micronutrient intake. The cognitive test battery included measures from the Wechsler Adult Intelligence Scale-III (WAIS-III; Wechsler et al., 2008), Wechsler Memory Scale-IV (WMS-IV; Wechsler, 2009) and Delis-Kaplan Executive Function System (D-KEFS; Delis et al., 2001), along with the Doors and People (Baddeley et al., 1994) and a serial reaction time task. Analyses showed better performance on some tasks in all groups following the intervention period, notably on measures of verbal and visual memory and visuomotor processing speed. The Multivitamin group showed significant improvements on tasks of visual strategy generation (along with the Vitamin C group), motor planning, explicit and implicit learning, and working memory. This evidence suggests that sub-optimal micronutrient intake may have a negative effect on cognition across the lifespan.
... In contrast, other studies found an association between multivitamin supplementation, faster and more accurate numerical processing in healthy adults (Haskell et al., 2010;Kennedy et al., 2010), improved choice reaction time in children (Haskell et al., 2008), and improved immediate verbal memory and fluency in cognitively healthy older adults (Grima et al., 2012) compared to baseline performance. The picture is far from clear however as contrasting findings have been shown with the same supplement (Swisse Men's Ultivite) in similar cohorts (males between 50 and 74 years), using the same computerized cognitive battery (Pipingas et al., 2010(Pipingas et al., , 2014Harris et al., 2012). Pipingas et al. (2014) found improvement from baseline in selective attention and response inhibition that trended toward significance following 16 weeks of supplementation, whereas Harris et al. (2012) found significant improvements from baseline in recognition memory after 8 weeks of supplementation. ...
... The picture is far from clear however as contrasting findings have been shown with the same supplement (Swisse Men's Ultivite) in similar cohorts (males between 50 and 74 years), using the same computerized cognitive battery (Pipingas et al., 2010(Pipingas et al., , 2014Harris et al., 2012). Pipingas et al. (2014) found improvement from baseline in selective attention and response inhibition that trended toward significance following 16 weeks of supplementation, whereas Harris et al. (2012) found significant improvements from baseline in recognition memory after 8 weeks of supplementation. Despite the differences in length of supplement period both studies found significant change in blood plasma levels of B 6 , B 12 , folate and homocysteine (Harris et al., 2012;Pipingas et al., 2014) indicating that changes in blood levels and cognitive function can be seen over a relatively short 8 week period of supplementation. ...
... Pipingas et al. (2014) found improvement from baseline in selective attention and response inhibition that trended toward significance following 16 weeks of supplementation, whereas Harris et al. (2012) found significant improvements from baseline in recognition memory after 8 weeks of supplementation. Despite the differences in length of supplement period both studies found significant change in blood plasma levels of B 6 , B 12 , folate and homocysteine (Harris et al., 2012;Pipingas et al., 2014) indicating that changes in blood levels and cognitive function can be seen over a relatively short 8 week period of supplementation. These findings are encouraging because they indicate that even brief nutritional enhancement can significantly elevate circulating micronutrient levels, presumably with beneficial effects for health, although it is less clear why different elements of cognition were altered in the different studies. ...
The impact of poor nutrition on physiological health is well understood (Costarelli et al., 2013). Less is known about the effects of diet on brain function and cognition in the general population (Ames, 2010; Parletta et al., 2013; White et al., 2017) and we are still in the early stages of understanding the role of specific nutrients to normal and pathological neuronal functioning. In the present study, the putative effect of a multivitamin/mineral or vitamin D supplement on cognitive function over an 8-week period was compared with volunteers taking vitamin C. Healthy adults (N = 60) were recruited, age range 21-59 years (
x
¯
= 39.07 years, SD = 11.46), with participants randomly allocated to conditions in a double-blind protocol. Participants also completed a 14-day food diary to gather information on micronutrient intake. The cognitive test battery included measures from the Wechsler Adult Intelligence Scale-III (WAIS-III; Wechsler et al., 2008), Wechsler Memory Scale-IV (WMS-IV; Wechsler, 2009) and Delis-Kaplan Executive Function System (D-KEFS; Delis et al., 2001), along with the Doors and People (Baddeley et al., 1994) and a serial reaction time task. Analyses showed better performance on some tasks in all groups following the intervention period, notably on measures of verbal and visual memory and visuomotor processing speed. The Multivitamin group showed significant improvements on tasks of visual strategy generation (along with the Vitamin C group), motor planning, explicit and implicit learning, and working memory. This evidence suggests that sub-optimal micronutrient intake may have a negative effect on cognition across the lifespan.
... In younger adult females, 63 days of MVM supplementation were associated with improved cognitive performance on a multi-tasking paradigm, with a concomitant reduction in subjective fatigue associated with task completion [33]. As part of the 16-week trial MVM supplementation with additional herbal ingredients, Pipingas et al. [34] reported limited evidence of cognitive changes associated with MVM supplementation. Improvements in performance on the Stroop task were noted within the male sample; however, this trend failed to reach significance when correcting for multiple comparisons. ...
... Improvements in performance on the Stroop task were noted within the male sample; however, this trend failed to reach significance when correcting for multiple comparisons. Within this male sample receiving MVM treatment, the trend towards changing Stroop performance was correlated with the change in blood levels of vitamin B6 [34]. ...
... It is important to note that these tasks were primarily implemented as activation tasks as part of functional brain activity assessments (to be reported elsewhere) and, as such, may not be maximally sensitive to detecting changes in cognitive performance. Indeed, previous studies to demonstrate cognitive performance changes in healthy young adults have utilised relatively extensive computerised cognitive assessment and/or multi-tasking batteries [26,33,34], suggesting validated, highly demanding assessments across a range of cognitive domains remain an important avenue for future research in order to fully characterise the effects of MVM supplementation in healthy adults [32]. ...
This study explored the effects of four-week multi-vitamin and mineral (MVM) supplementation on mood and neurocognitive function in healthy, young adults. Fifty-eight healthy adults, 18-40 years of age (M = 25.82 years, SD = 4.87) participated in this randomised, double-blind, placebo-controlled trial, in which mood and blood biomarkers were assessed at baseline and after four weeks of supplementation. Compared to placebo, MVM supplementation was associated with significantly lowered homocysteine and increased blood B-vitamin levels (p < 0.01). MVM treatment was also associated with significantly improved mood, as measured by reduced scores on the "depression-dejection" subscale of the Profile of Mood States (p = 0.018). These findings suggest that the four weeks of MVM supplementation may have beneficial effects on mood, underpinned by elevated B-vitamins and lowered homocysteine in healthy young adults.
... In healthy adults, 90 days of high-dose vitamin B multivitamin supplementation has been shown to reduce negative mood states of personal strain, confusion, and depression [7]. More generally, multivitamin supplementation for four weeks has been shown to reduce depressive states [9], stress, anxiety, and tiredness [17], whereas 9-week supplementation reduced fatigue and improved performance during a cognitive task [5], and 16-week supplementation improved Stroop task performance for men but not women [18]. However, the improvement in cognitive performance is task-specific. ...
... However, the improvement in cognitive performance is task-specific. For example, supplementation improved immediate recall, mental speed, and number facility, but not reasoning, delayed recall, or verbal fluency (for a review, see Reference [10]), and no improvement in reaction time or memory have been reported [18]. Acute multivitamin supplementation has also been shown to improve contentment and cognitive task performance in adults [8]. ...
A diet rich in B-group vitamins is essential for optimal body and brain function,
and insufficient amounts of such vitamins have been associated with higher levels of neural
inflammation and oxidative stress, as marked by increased blood plasma homocysteine.
Neural biomarkers of oxidative stress quantified through proton magnetic spectroscopy (1H-MRS) are not well understood, and the relationship between such neural and blood biomarkers is seldom studied. The current study addresses this gap by investigating the direct effect of 6-month high-dose B-group vitamin supplementation on neural and blood biomarkers of metabolism. Using a randomized, double-blind, placebo-controlled design, 32 healthy adults (20 female, 12 male) aged 30–65 years underwent blood tests (vitamin B6, vitamin B12, folate, and homocysteine levels) and 1H-MRS of the posterior cingulate cortex (PCC) and dorsolateral prefrontal cortex (DLPFC) before and after supplementation. Results confirmed the supplement was effective in increasing vitamin B6 and vitamin B12 levels and reducing homocysteine, whereas there was no change in folate levels.
There were significant relationships between vitamin B6 and N-acetylaspartate (NAA), choline, and creatine, as well as between vitamin B12 and creatine (ps < 0.05), whereas NAA in the PCC increased, albeit not significantly (p > 0.05). Together these data provide preliminary evidence for the efficacy of high-dose B-group supplementation in reducing oxidative stress and inflammation through increasing oxidative metabolism. It may also promote myelination, cellular metabolism, and energy storage.
... It is also worth noting that a number of other recent studies have also demonstrated improved psychological or cognitive functioning following products containing multi-vitamins [167][168][169][170][171], although the interpretation of these studies with regards their vitamin content is limited by the inclusion of multiple herbal extracts at potentially psychoactive levels in the formulations. However, it may be relevant that one of these studies demonstrated a correlation between improved performance in a focussed attention (Stroop) task and changes in blood levels of vitamin B 6 following supplementation [170]. ...
... It is also worth noting that a number of other recent studies have also demonstrated improved psychological or cognitive functioning following products containing multi-vitamins [167][168][169][170][171], although the interpretation of these studies with regards their vitamin content is limited by the inclusion of multiple herbal extracts at potentially psychoactive levels in the formulations. However, it may be relevant that one of these studies demonstrated a correlation between improved performance in a focussed attention (Stroop) task and changes in blood levels of vitamin B 6 following supplementation [170]. ...
The B-vitamins comprise a group of eight water soluble vitamins that perform essential, closely inter-related roles in cellular functioning, acting as co-enzymes in a vast array of catabolic and anabolic enzymatic reactions. Their collective effects are particularly prevalent to numerous aspects of brain function, including energy production, DNA/RNA synthesis/repair, genomic and non-genomic methylation, and the synthesis of numerous neurochemicals and signaling molecules. However, human epidemiological and controlled trial investigations, and the resultant scientific commentary, have focused almost exclusively on the small sub-set of vitamins (B₉/B12/B₆) that are the most prominent (but not the exclusive) B-vitamins involved in homocysteine metabolism. Scant regard has been paid to the other B vitamins. This review describes the closely inter-related functions of the eight B-vitamins and marshals evidence suggesting that adequate levels of all members of this group of micronutrients are essential for optimal physiological and neurological functioning. Furthermore, evidence from human research clearly shows both that a significant proportion of the populations of developed countries suffer from deficiencies or insufficiencies in one or more of this group of vitamins, and that, in the absence of an optimal diet, administration of the entire B-vitamin group, rather than a small sub-set, at doses greatly in excess of the current governmental recommendations, would be a rational approach for preserving brain health.
... 80 The synthesis of neurotransmitters is sanative to B vitamin levels and potential effects on cognition. 81,82 Specifically, vitamin B6 has been shown to be an important nutrient for cognition, 83 with vitamin B12 being found to be an important coenzyme that assists in DNA synthesis and is necessary for the formation of red blood cells and for brain health. 84 B vitamins are generally synthesized by plants, within the chloroplasts, mitochondria, and the cytosol, regulating the plant's functional requirements. ...
Cognitive aging in humans is considered a normal part of aging with minor declines in mental functions such as vocabulary, numerical skills, and general knowledge. Cognitive aging typically begins from middle age onward, although some mental capabilities begin to decline even earlier. As there is currently no available medical intervention available to treat cognitive decline, early intervention through the use of modifiable risk factors is imperative in middle age to prevent the onset and progression of cognitive decline into mild cognitive impairment (MCI) and Alzheimer’s disease (AD).
Previous research suggests that various lifestyle interventions, which modify the risk for conditions including obesity, sedentary lifestyle, hypertension, depression, cardiovascular disease, potentially arterial stiffness, oxidative stress, and hyperlipidemia, have the ability to reduce the risk for cognitive decline (Parrott and Greenwood, 2007; Mathers, 2013; Dauncey, 2014; Kiefte-De Jong et al., 2014; Vandewoude et al., 2016). The impact of how dietary changes and dietary patterns such as the Mediterranean diet may modify age-associated changes in cognitive function is the focus of this chapter.
... Nonetheless, some studies do suggest that dietary supplements may modulate some aspects of cognitive performance in healthy young adults. Supplements that have shown some cognitive benefits result from omega-3 [28,29], multivitamins and minerals [30,31] and caffeine [32]. ...
Intake of dietary supplements has increased, despite evidence that some of these have adverse side effects and uncertainty about their effectiveness. This systematic review examined the evidence for the cognitive benefits of a wide range of dietary supplements in healthy young adult samples; the aim was to identify if any might be useful for optimising cognitive performance during deployment in military personnel. Searches were conducted in 9 databases and 13 grey literature repositories for relevant studies published between January 2000 and June 2017. Eligible studies recruited healthy young adults (18–35 years), administered a legal dietary supplement, included a comparison control group, and assessed cognitive outcome(s). Thirty-seven of 394 identified studies met inclusion criteria and were included for synthesis. Most research was deemed of low quality (72.97%; SIGN50 guidelines), highlighting the need for sound empirical research in this area. Nonetheless, we suggest that tyrosine or caffeine could be used in healthy young adults in a military context to enhance cognitive performance when personnel are sleep-deprived. Caffeine also has the potential benefit of improving vigilance and attention during sustained operations offering little opportunity for sleep. Inconsistent findings and methodological limitations preclude firm recommendations about the use of other specific dietary supplements.
... Indeed, there is growing evidence for neurocognitive benefits of MVM supplementation in non-clinical populations. For example, in a 16-week trial of a MVM supplementation in healthy young adults, improved attentional performance in males was significantly correlated with increased levels of vitamin B 6 ( 83) . This strongly suggests a functional role for Fig. 3. Increased activation of a working memory network following administration of a broad-spectrum B vitamin and mineral (MVM) preparation compared with placebo (MVM > placebo), using two neuroimaging modalities (with warmer colour indicate greater difference over placebo). ...
Effective pharmaceutical treatments for age-related cognitive decline have proved elusive. There is, however, compelling evidence that nutritional status and supplementation could play crucial roles in modifying the expression of cognitive change through the lifespan. Subjective memory impairment and mild cognitive impairment can be harbingers of dementia but this is by no means inevitable. Neurocognitive change is influenced by a variety of processes, many of which are involved in other aspects of systemic health, including cardiovascular function. Importantly, many of these processes are governed by mechanisms which may be modified by specific classes of bioactive nutrients. There is increasing, converging evidence from controlled trials that nutritional interventions can improve mood and cognitive function in both clinical and healthy populations. Specific examples include selected botanical extracts such as the flavonoids. Some nutritional supplements (e.g. broad-spectrum micronutrient supplementation) appear to support improved cognitive function, possibly through redressing insufficient nutrient status (i.e. suboptimal but above the threshold for frank deficiency). Recent mechanistic research has unveiled physiologically plausible, modifiable, cognition-relevant targets for nutrition and nutraceuticals. These include processes involved in both systemic and central vascular function, inflammation, metabolism, central activation, improved neural efficiency and angiogenesis. The advent and development of human neuroimaging methodology have greatly aided our understanding of the core central mechanisms of cognitive change. Different imaging modalities can provide insights into modifiable central mechanisms which may be targeted by bioactive nutrients. The latter may contribute to slowing age-related decline through supporting neurocognitive scaffolding mechanisms.
... From the nine randomized clinical trials in the general population, eight showed that although vitamin supplementation reduced the Hcy levels, this did not impact the cognitive test scores (123)(124)(125)(126)(127)(128)(129)(130). However, improved cognitive performance was observed in one article where the vitamin supplementation reduced the Hcy levels. ...
Background:
Elevated plasma homocysteine (Hcy) levels have been associated with cognitive dysfunction in a wide range of conditions. The aim of this review is to establish which cognitive domains and populations are the most affected.
Methods:
We systematically review the literature and consider all articles that showed any relationship between plasma Hcy levels and scores achieved on cognitive performance tests in both, the general population and patients suffering from central nervous system disorders and other diseases. When effect sizes were available and combinable, several meta-analyses were performed.
Results:
We found 111 pertinent articles. There were 24 cohort studies, 18 randomized trials, 21 case-control studies, and 48 cross-sectional studies. This review reveals a positive trend between cognitive decline and increased plasma Hcy concentrations in general population and in patients with cognitive impairments. Results from the meta-analyses also confirm this trend. Treatment with vitamin supplementation fails to show a reduction in cognitive decline.
Discussion:
Further investigations are warranted to clarify this relationship. Earlier detection of the elevated Hcy levels may be an effective intervention to prevent cognitive impairment and dementia.
... Manufacturers market many micronutrients and dietary supplement ingredients as cognitive performance enhancers; however, researchers have not been able to document consistent benefits to cognitive performance with multivitamin-, mineral-, or botanical-containing supplements in the absence of a deficiency. 73 Data from recently published studies have shown that 72% of military personnel reported consuming an energy drink or shot, primarily for cognitive enhancement, within the last 30 days of completing the study questionnaire. 74 A group within SOF has been shown to consume an ergogenic dose of caffeine daily. ...
Special Operations Forces (SOF) training, combat, and contingency operations are unique and demanding. Performance nutrition within the Department of Defense has emphasized that nutrition is relative to factors related to the desired outcome, which includes successful performance of mentally and physically demanding operations and missions of tactical and strategic importance, as well as nonoperational assignments. Discussed are operational, nonoperational, and patient categories that require different nutrition strategies to facilitate category-specific performance outcomes. Also presented are 10 major guidelines for a SOF comprehensive performance nutrition program, practical nutrition recommendations for Special Operators and medical providers, as well as resources for dietary supplement evaluation. Foundational health concepts, medical treatment, and task-specific performance factors should be considered when developing and systematically implementing a comprehensive SOF performance nutrition program. When tailored to organizational requirements, SOF unit- and culture-specific nutrition education and services can optimize individual Special Operator performance, overall unit readiness, and ultimately, mission success.
2015.
... 18 The intake of multivitamin supplements in men increases selective attention which is associated with increased blood vitamin B6 levels. 19 Moreover, caffeine supplementation is effective in improving attention and increasing alertness in adolescents and adults. 20,21 Consumption of different food groups is also associated with general cognition. ...
Objective A low antioxidants status has been shown to result in oxidative stress and cognitive impairment. Because antioxidants can protect the nervous system, it is expected that a better blood antioxidant status might be related to sustained attention. However, the relationship between the blood antioxidant status and visual and auditory sustained attention has not been investigated. The aim of this study was to evaluate the association of fruits and vegetables intake and the blood antioxidant status with visual and auditory sustained attention in women. Method This cross-sectional study was performed on 400 healthy women (20-50 years) who attended the sports clubs of Tehran Municipality. Sustained attention was evaluated based on the Integrated Visual and Auditory Continuous Performance Test using the Integrated Visual and Auditory (IVA) software. The 24-hour food recall questionnaire was used for estimating fruits and vegetables intake. Serum total antioxidant capacity (TAC), and erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured in 90 participants. Results After adjusting for energy intake, age, body mass index (BMI), years of education and physical activity, higher reported fruits, and vegetables intake was associated with better visual and auditory sustained attention (P < 0.001). A high intake of some subgroups of fruits and vegetables (i.e. berries, cruciferous vegetables, green leafy vegetables, and other vegetables) was also associated with better sustained attention (P < 0.02). Serum TAC, and erythrocyte SOD and GPx activities increased with the increase in the tertiles of visual and auditory sustained attention after adjusting for age, years of education, physical activity, energy, BMI, and caffeine intake (P < 0.05). Discussion Improved visual and auditory sustained attention is associated with a better blood antioxidant status. Therefore, improvement of the antioxidant status through an appropriate dietary intake can possibly enhance sustained attention.
... Tablets containing vitamins B 6 , B 9 , and B 12 administered for 4 months improved the Stroop test of divided attention in young subjects[365]. In addition, tablets containing vitamins B 1, B 6 , B 9 , and B 12 administered for 9 weeks improved the same test as well as a series of mathematical problems[366]. ...
... Furthermore, as these studies are limited to young adults and children, it is not known whether a single multivitamin dose would benefit cognition or mood in older people. We have previously suggested that chronic multivitamin use may be expected to exert greater effects in older people who are at great risk of nutritional deficiency and cognitive decline Pipingas et al. 2014), but whether the same benefits would be observed following the administration of a single supplement has not been explored in older adults. ...
A number of randomised controlled trials have indicated that multivitamin/mineral supplementation for a period of 4 weeks or greater can enhance mood and cognition. To date, no studies have investigated whether a single multivitamin dose can benefit mental function in older adults. This study investigated the acute effects of a single multivitamin and mineral and herbal (MVMH) supplement versus placebo on self ratings of mood and the performance of an effortful computerised cognitive battery in a sample of 76 healthy women aged 50-75 years. Mood was assessed using the depression anxiety stress scale (DASS), state trait anxiety inventory-state anxiety scale and visual analogue scales (VAS). Mood was rated at 1 h post supplementation and again after the competition of the cognitive assessments at 2 h post supplementation. It was demonstrated that the MVMH supplement improved overall DASS mood ratings; however, the most prominent effects appeared to be a reduction in ratings of perceived mental stress. These findings were confirmed using visual analogue scales, with these measures also demonstrating MVMH-related increased ratings of calmness. There were no benefits of the MVMH to mood ratings of depression and performance was not enhanced on the cognitive battery. Supplementation with a single multivitamin, mineral and herbal supplement reduces stress several hours after intake in healthy older people.
The body composition of a squash player may affect athletic performance as carrying excessive body fat may increase injury risk and impair agility and speed. This case study outlines the effect of a nutritional intervention on body composition, vitamin D status and physical performance of a female squash player. A structured, 6-week moderate energy-restricted diet (70-78% of Estimated Energy Requirement (EER) of 2300 kcal was implemented with weekly support. A daily supplement of vitamin D, omega 3 fatty acids, and a multivitamin/multimineral and whey protein was used. Full blood count, vitamin D status, body composition and physical performance assessments where carried out at baseline and week six of intervention. Body composition changes were measured using the Bodpod and skinfold calipers. Body fat at baseline was 23% and 22% at week 6. Mean sum of 8 skinfolds at baseline was 127.4 mm (SD ± 2.2) and 107.3 mm (SD ± 0.4) at week 6. LBM to fat mass ratio improved from 3.4 at baseline to 3.7 at week six. The greatest increments compared to baseline in serum markers were 25-hydroxy vitamin D3 (68%), ferritin (31%), eosinphils (20%) and triglycerides (16%). All physical performance measures improved, with Reactive Strength Index (4.8%), and on-court repeated speed (6.0%) showing the greatest improvements from baseline. This intervention demonstrates that structured energy restriction alongside appropriately structured strength and conditioning training is an effective way to gradually reduce body fat and improve the body composition of a female athlete.
Vitamin B6 represents a group of substances with vitamin B activity. They are derivatives of 3-hydroxy-2-methylpyridine: pyridoxine (PN, alcohol), pyridoxal (PL, aldehyde), pyridoxamine (PM, amine) and their 5′-phosphorylated forms. PLP serves mainly as a coenzyme for about 100 enzymes in amino acid metabolism in the way of transamination, decarboxylation, and elimination. PMP exclusively acts as a coenzyme for transaminases (transferase, oxidoreductase, hydrolase, lyase). Vitamin B6 has many functions in various systems of the body (immune system, nervous system, gluconeogenesis, lipid metabolism, erythrocyte function, hormone modulation, gene expression, niacin formation). Deficiency symptoms are hard to diagnose and equal those of deficiencies of niacin and riboflavin. In context with high homocysteine levels dementia may occur. Some drugs reduce vitamin B6 concentration, especially when they are taken chronically (then vitamin B6 status should be monitored): hydrazines, chelators, antibiotics, oral contraceptives, l-dopa, alcohol. In developed countries, a mixed diet is sufficient to take up the recommended 1.5/1.2 mg day⁻¹ for males and females, respectively.
Event-related potentials were recorded by 18 college students (aged 21–33 yrs) in a hybrid go/no-go Eriksen flanker task to study the neural correlates of response inhibition. Three letters were assigned to either a left-hand, a right-hand, or a no-go response. These three letters appeared either as targets signaling the assigned response or as flankers surrounding the target. The lateralized readiness potentials revealed erroneous cortical response priming on go trials, in which the target and flankers were assigned to different hands, as well as on no-go trials, in which the flankers primed one of the two hands. Exactly these two conditions were accompanied by a fronto-central amplitude modulation of the N200, suggesting that this ERP component may reflect inhibitory executive functions. The data replicate and extend recent studies by B. Kopp et al (1996). (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Complementary medicine use is becoming increasingly popular with multivitamins being the most commonly used vitamin supplement. Although adequate vitamin and nutrient concentrations are necessary for optimal health and cognitive functioning, there is no scientific consensus as to whether multivitamin use prevents cognitive decline or improves mental functioning. The aim of the present study was to determine if multivitamins can be used efficaciously to improve cognitive abilities. A systematic review of randomized controlled trials was performed. Meta-analysis was performed on those cognitive tests used across the largest number of studies. Multiple electronic databases were searched until July 2011 by two authors. Randomized, placebo-controlled trials were considered appropriate if they reported on the chronic effects (≥1 month) of oral multivitamin supplementation on any valid cognitive outcomes. Ten trials were included in review (n = 3,200). Meta-analysis indicated that multivitamins were effective in improving immediate free recall memory (SMD = 0.32; 95% CI: 0.09-0.56, p < 0.01) but not delayed free recall memory (SMD = -0.14; 95% CI: -0.43-0.14, p = 0.33) or verbal fluency (SMD = 0.06; 95% CI: -0.05-0.18, p = 0.26). There was no evidence of publication bias or heterogeneity. Other cognitive abilities sensitive to AD pathology, such as executive and visuospatial functions, were found to be under researched. In conclusion, multivitamins were found to enhance immediate free recall memory but no other cognitive domains.
The role of vitamin status in the development of the brain and the subsequent functioning of the brain was considered. There are data with a range of vitamins, from animal studies and human studies in developing countries, suggesting that a clinical deficiency during the critical period when the brain is developing causes permanent damage. To date there is, however, with the exception of cases of clinical deficiency such as those that might be associated with a vegan diet, little evidence that variations in the diet of those living in industrialised countries have a lasting developmental influence. Similarly, later in life clinical deficiencies of various vitamins disrupt cognition although there is to date limited evidence that variations in the intake of single vitamins in industrialised societies influence functioning. It may well be, however, unreasonable to expect that vitamins examined in isolation will be associated with differences in cognitive functioning. The output of the brain reflects millions of metabolic processes, each potentially susceptible to any of a range of vitamins. A diet poor in one respect is likely to be poor in other respects as well. As such, the preliminary reports in double-blind placebo-controlled trials that aspects of cognition and behaviour respond to supplementation with multi-micronutrients may indicate the way forward.
There is potential for multivitamin supplementation to improve cognition in the elderly. This randomized, double-blind, placebo-controlled trial was conducted to investigate the effects of 16 weeks multivitamin supplementation (Swisse Women's 50+ Ultivite ®) on cognition in elderly women.
Participants in this study were 56 community dwelling, elderly women, with subjective complaints of memory loss. Cognition was assessed using a computerized battery of memory and attention tasks designed to be sensitive to age-related declines to fluid intelligence, and a measure of verbal recall. Biochemical measures of selected nutrients, homocysteine, markers of inflammation, oxidative stress, and blood safety parameters were also collected. All cognitive and haematological parameters were assessed at baseline and 16 weeks post-treatment.
The multivitamin improved speed of response on a measure of spatial working memory, however benefits to other cognitive processes were not observed. Multivitamin supplementation decreased levels of homocysteine and increased levels of vitamin B(6) and B(12), with a trend for vitamin E to increase. There were no hepatotoxic effects of the multivitamin formula indicating this supplement was safe for everyday usage in the elderly.
Sixteen weeks ssupplementation with a combined multivitamin, mineral and herbal formula may benefit working memory in elderly women at risk of cognitive decline.
A significant proportion of the general population report supplementing their diet with one or more vitamins or minerals, with common reasons for doing so being to combat stress and fatigue and to improve mental functioning. Few studies have assessed the relationship between supplementation with vitamins/minerals and psychological functioning in healthy cohorts of non-elderly adults.
The present randomised, placebo-controlled, double-blind, parallel groups trial assessed the cognitive and mood effects of a high-dose B-complex vitamin and mineral supplement (Berocca(R)) in 215 males aged 30 to 55 years, who were in full-time employment.
Participants attended the laboratory prior to and on the last day of a 33-day treatment period where they completed the Profile of Mood States (POMS), Perceived Stress Scale (PSS) and General Health Questionnaire (GHQ-12). Cognitive performance and task-related modulation of mood/fatigue were assessed with the 60 min cognitive demand battery. On the final day, participants also completed the Stroop task for 40 min whilst engaged in inclined treadmill walking and subsequent executive function was assessed.
Vitamin/mineral supplementation led to significant improvements in ratings on the PSS, GHQ-12 and the 'vigour' subscale of the POMS. The vitamin/mineral group also performed better on the Serial 3s subtractions task and rated themselves as less 'mentally tired' both pre- and post-completion of the cognitive demand battery.
Healthy members of the general population may benefit from augmented levels of vitamins/minerals via direct dietary supplementation. Specifically, supplementation led to improved ratings of stress, mental health and vigour and improved cognitive performance during intense mental processing.
This study evaluates the effects of vitamin B-6 supplementation (20 mg pyridoxine HCL daily for 3 months) on mood and performance in 38 self-supporting healthy men, aged between 70-79 years. Effects were compared with 38 controls who received placebo and were matched for age, plasma pyridoxal-5'-phosphate (PLP) concentration and intelligence score. Before and after drug intervention vitamin B-6 status was determined, and mood and performance were measured by means of a computerized testing system. In addition, the phasic pupil response was measured in order to assess mental effort. Positive effects of vitamin B-6 supplementation were only found with respect to memory, especially concerning long-term memory. In view of the finding that mental performance improvement and delta PLP values were most strongly correlated within an intermediate range of delta PLP, it is suggested that cognitive effects are primarily associated with a certain range of vitamin B-6 status increment. The general conclusion is that vitamin B-6 supplementation improves storage of information modestly but significantly.
Based on research demonstrating associations between folate, B-12 and B-6 vitamins and cognition and mood, we investigated the effects of short-term supplementation in 211 healthy younger, middle-aged and older women who took either 750 microg of folate, 15 microg of vitamin B-12, 75 mg of vitamin B-6 or a placebo daily for 35 d. In addition, we examined associations between dietary intake of these vitamins and cognition and mood. Usual dietary intake status was estimated using a retrospective, self-report, quantified food frequency questionnaire. Participants completed alternate forms of standardized tests of cognitive processing resources, memory, executive function, verbal ability and self-report mood measures before and after supplementation. Supplementation had a significant positive effect on some measures of memory performance only, and no effect on mood. Dietary intake status was associated with speed of processing, recall and recognition and verbal ability.
Acute doses of Ginkgo biloba have been shown to improve attention and memory in young, healthy participants, but there has been a lack of investigation into possible effects on executive function. In addition, only one study has investigated the effects of chronic treatment in young volunteers.
This study was conducted to compare the effects of ginkgo after acute and chronic treatment on tests of attention, memory and executive function in healthy university students.
Using a placebo-controlled double-blind design, in experiment 1, 52 students were randomly allocated to receive a single dose of ginkgo (120 mg, n=26) or placebo (n=26), and were tested 4 h later. In experiment 2, 40 students were randomly allocated to receive ginkgo (120 mg/day; n=20) or placebo (n=20) for a 6-week period and were tested at baseline and after 6 weeks of treatment. In both experiments, participants underwent tests of sustained attention, episodic and working memory, mental flexibility and planning, and completed mood rating scales.
The acute dose of ginkgo significantly improved performance on the sustained-attention task and pattern-recognition memory task; however, there were no effects on working memory, planning, mental flexibility or mood. After 6 weeks of treatment, there were no significant effects of ginkgo on mood or any of the cognitive tests.
In line with the literature, after acute administration ginkgo improved performance in tests of attention and memory. However, there were no effects after 6 weeks, suggesting that tolerance develops to the effects in young, healthy participants.
Five-year changes in episodic and semantic memory were examined in a sample of 829 participants (35–80 years). A cohort-matched sample (N = 967) was assessed to control for practice effects. For episodic memory, cross-sectional analyses indicated gradual age-related decrements, whereas the longitudinal data revealed no decrements before age 60, even when practice effects were adjusted for. Longitudinally, semantic memory showed minor increments until age 55, with smaller decrements in old age as compared with episodic memory. Cohort differences in educational attainment appear to account for the discrepancies between cross-sectional and longitudinal data. Collectively, the results show that age trajectories for episodic and semantic memory differ and underscore the need to control for cohort and retest effects in cross-sectional and longitudinal studies, respectively.
Emerging evidence suggests that dietary phytochemicals, in particular flavonoids, may exert beneficial effects on the central nervous system by protecting neurons against stress-induced injury, by suppressing neuroinflammation and by improving cognitive function. It is likely that flavonoids exert such effects, through selective actions on different components of a number of protein kinase and lipid kinase signalling cascades, such as the phosphatidylinositol-3 kinase (PI3K)/Akt, protein kinase C and mitogen-activated protein kinase (MAPK) pathways. This review explores the potential inhibitory or stimulatory actions of flavonoids within these pathways, and describes how such interactions are likely to underlie neurological effects through their ability to affect the activation state of target molecules and/or by modulating gene expression. Future research directions are outlined in relation to the precise site(s) of action of flavonoids within signalling pathways and the sequence of events that allow them to regulate neuronal function.
Adequate levels of vitamins and minerals are essential for optimal neural functioning. A high proportion of individuals, including children, suffer from deficiencies in one or more vitamins or minerals. This study investigated whether daily supplementation with vitamins/minerals could modulate cognitive performance and mood in healthy children. In this randomised, double-blind, placebo-controlled, parallel groups investigation, eighty-one healthy children aged from 8 to 14 years underwent laboratory assessments of their cognitive performance and mood pre-dose and at 1 and 3 h post-dose on the first and last days of 12 weeks' supplementation with a commercially available vitamins/mineral product (Pharmaton Kiddi). Interim assessments were also completed at home after 4 and 8 weeks at 3 h post-dose. Each assessment comprised completion of a cognitive battery, delivered over the Internet, which included tasks assessing mood and the speed and accuracy of attention and aspects of memory (secondary, semantic and spatial working memory). The vitamin/mineral group performed more accurately on two attention tasks: 'Arrows' choice reaction time task at 4 and 8 weeks; 'Arrow Flankers' choice reaction time task at 4, 8 and 12 weeks. A single task outcome (Picture Recognition errors) evinced significant decrements at 12 weeks. Mood was not modulated in any interpretable manner. Whilst it is possible that the significant improvements following treatment were due to non-significant numerical differences in performance at baseline, these results would seem to suggest that vitamin/mineral supplementation has the potential to improve brain function in healthy children. This proposition requires further investigation.
With many nutraceutical interventions designed to slow cognitive aging, there is a need for computerised tests that can detect small cognitive changes that may occur in response to these interventions. A battery of 13 computerised cognitive tasks was developed to capture the range of cognitive functions that decline with age. One hundred and twenty adults aged 21 to 86 years, with a MMSE score ≥27 completed the test battery. Accuracy and response time were measured. Regression analysis revealed age-related decrements in cognitive performance for all tasks. Performance accuracy for the Spatial Working Memory task and speed of response for Spatial Working Memory, Contextual Memory and Immediate Recognition tasks showed the greatest age-related decline. The tasks showed good test-retest reliability and correlated with other commonly used neuropsychological tests in aging research. With the sensitivity of this cognitive test battery to aging it may be useful in future studies investigating cognitive improvements in response to nutraceutical interventions in older adults.
The elderly are at risk of nutritional deficiency for a number of reasons, and as vitamins and minerals are crucially involved in the formation of certain neurotransmitters, such deficiency may result in impaired cognitive functioning. The objectives of the study were to examine the relationship between vitamin status and cognitive functioning and mood in healthy, elderly volunteers and to assess the subsequent impact of multivitamin supplementation on these measures. A double-blind, placebo-controlled, parallel group study was carried out with 139 healthy, elderly volunteers (60-83 years) being randomly allocated to daily treatment with multivitamins or placebo for up to 24 weeks. Assessments of blood vitamin levels, cognitive functioning and mood were performed at baseline and at 12-weekly intervals thereafter. This population was deficient in various vitamins, particularly vitamins B-2, B-6 and B-12. Various correlations between vitamin levels and cognitive functioning were observed at baseline, but although multivitamin supplementation increased blood vitamin levels, it had very little effect on performance. Short-term multivitamin supplementation in healthy, elderly volunteers had little effect on cognitive function or mood. However, vitamin status correlated with certain measures at baseline, and therefore it is possible that supplementation over longer periods of time and/or in volunteers with poorer nutritional status may prove beneficial.
Nutritional and vitamin status may be related to cognitive function and decline in older adults. The aim of this study was to investigate the effects of nutritional supplementation on cognition in older men.
The current study was an 8-week, placebo-controlled, double-blind investigation into the effects of a multivitamin, mineral and herbal supplement (Swisse Men's Ultivite®, Swisse Vitamins Pty Ltd, Melbourne, Australia) on cognitive performance in older men. Participants were 51 male individuals aged between 50 and 74 years, with a sedentary lifestyle. Cognitive performance was assessed at baseline and post-treatment using a computerised battery of cognitive tasks, enabling the measurement of a range of attentional and memory processes. Blood measures of vitamin B(12) , folate and homocysteine were collected prior to and after supplementation.
The results of this study revealed that contextual recognition memory performance was significantly improved following multivitamin supplementation (p < 0.05). Performance on other cognitive tasks did not change. Levels of vitamin B(12) and folate were significantly increased with a concomitant decrease in homocysteine, indicating that relatively short-term supplementation with a multivitamin can benefit these risk factors for cognitive decline.
Findings from this study indicate that daily multivitamin supplementation may improve episodic memory in older men at risk of cognitive decline.
Vitamin supplements are consumed for their purported health benefits by a large segment of the populations of developed countries. Several indirect strands of evidence suggest that increasing levels of vitamins may improve brain function. These include evidence that individual vitamins are intrinsically involved in the cellular and physiological processes underpinning brain function; that small proportions of the population exhibit biochemical deficiencies in each individual vitamin, suggesting that a much larger proportion have less than optimal overall micronutrient status; and that epidemiological research suggests a relationship between individual vitamins (or the potentially neurotoxic amino acid homocysteine, which is related to B vitamin status), and cognitive function and mood. The related question as to whether direct supplementation with vitamins can therefore improve psychological functioning in cognitively intact individuals has been addressed in a number of studies. The evidence reviewed here suggests that, whereas studies involving supplementation with single vitamins, or restricted ranges of vitamins, have demonstrated equivocal results, evidence from studies involving the administration of broader ranges of vitamins, or multivitamins, suggest potential efficacy in terms of cognitive and psychological functioning. In contrast to the literature investigating restricted ranges of vitamins, most of the evidence regarding multivitamins was collected from healthy, non-elderly samples, suggesting that more research in this population is warranted.
This study investigated the relation of midlife blood pressure, total cholesterol, body mass index (BMI), their changes over time, apolipoprotein E, and white matter lesions (WML).
Participants of the Cardiovascular Risk Factors, Aging and Incidence of Dementia study were derived from random, population-based samples previously surveyed in 1972, 1977, 1982 or 1987. In 1998, 1,449 (73%) individuals aged 65-79 years were re-examined (average follow-up 21 years). A subpopulation (n = 112) was scanned with a 1.5-tesla MRI scanner in 1998, and WML were assessed from fluid-attenuated inversion recovery images using a semi-quantitative visual rating scale.
Risk of late-life WML was related to midlife overweight (relative risk = 2.53; 95% CI = 1.70-2.89), obesity (2.94; 2.44-3.03), and hypertension (2.73; 1.81-3.08), even after adjustments for several confounding factors. Elevated BMI (>25) (2.26; 1.42-2.62) and hypertension (3.14; 1.83-3.40) from midlife to late life also increased the risk of WML. In addition, an association with WML was seen for decreasing blood pressure (hypertension at midlife but not at late life) (3.25; 2.46-3.41), even after controlling for antihypertensive treatment. Lipid-lowering drugs had a protective effect against WML (0.13; 0.02-0.59).
These results indicate that early and sustained vascular risk factor control is associated with a lower likelihood of having more severe WML in late life.
A significant minority of the population consume multi-vitamins/minerals for their putative health benefits, including potentially beneficial effects on cognitive performance, fatigue and mood. The current study investigated the effect of supplementation with a multi-vitamin/mineral on fatigue and cognitive function in healthy females.
In this placebo-controlled, double blind, randomized, parallel groups trial the effect of a multi-vitamin/mineral (Supradyn) was assessed in 216 females aged 25-50 years. Participants attended the laboratory before and 9 weeks after commencing treatment. During both visits cognitive function and the modulation of task related mood/fatigue were assessed in two discrete 20-min assessment periods during which participants completed a four-module version of the Multi-Tasking Framework.
Those in the vitamin/mineral group exhibited an attenuation of the negative effects of extended task completion on mood/fatigue. Multi-tasking performance for this group was also improved in terms of accuracy across all tasks, and on two of the individual tasks (Mathematical Processing and Stroop) in terms of both faster and more accurate responses. Analysis of a subsection (N = 102) demonstrated significant reductions in homocysteine levels following the vitamins/mineral supplement.
These findings suggest that healthy members of the general population may benefit from augmented levels of vitamins/minerals via direct dietary supplementation.
50-kHz ultrasonic vocalizations (USVs) emitted by adult rats are heterogeneous; they occur over a wide frequency range, show varying degrees of frequency modulation, and appear to differ in their behavioral significance. However, they have not been extensively categorized.
The main objective of this study was to identify subtypes of 50-kHz USVs emitted by adult rats and to determine how amphetamine (AMPH) or social testing condition affects their relative and absolute production rate and acoustic characteristics. A second objective was to determine the extent of individual differences in call rate, call subtype profile, and acoustic parameters (i.e., duration, bandwidth, and mean peak frequency).
Adult male Long-Evans rats were administered systemic amphetamine (0.25-2 mg/kg, IP) and tested individually or with a cage mate for 20 min. Call categories were defined based on visual inspection of over 20,000 USV spectrograms. Surgical devocalization was performed on a subset of AMPH-tested rats in order to confirm the authenticity of call subtypes.
Fourteen categories of 50-kHz USVs were recognized. Call subtypes were differentially affected by social context, AMPH dose, and time within session. In contrast, the acoustic characteristics of call subtypes were notably stable. Marked and stable inter-individual differences occurred with respect to overall 50-kHz call rate, acoustic parameters, and call profile.
The present findings, obtained under saline and amphetamine test conditions, provide the first detailed classification of adult rat 50-kHz USVs. Consideration of 50-kHz USV subtypes may advance our understanding of inter-rat communication and affective state.
Plasma homocysteine has been associated with reduced brain volumes in cross-sectional studies. We aimed to investigate if homocysteine is associated with ongoing atrophy, and if so, if this is localized to gray or white matter.
In a group of 80 hypertensive subjects aged 70-90 years (from the SCOPE study) MRI images were obtained at two time points two years apart. Rates of gray and white matter and hippocampal atrophy were determined by calculating the difference in segmentation probability maps using SPM5. Plasma homocysteine, folate, B12 and creatinine were measured at study end.
Homocysteine levels correlated with white matter atrophy rate (p = 0.006) hippocampal baseline volume (p = 0.011) and hippocampal atrophy rate (p = 0.004) but not global gray matter atrophy or baseline gray or white matter volumes. The correlations remained significant (p < 0.05) after controlling for subject age, blood pressure, folate levels and white matter lesion volume.
In older hypertensives, plasma homocysteine levels are associated with increased rates of progressive white matter and hippocampal atrophy.
Dietary interventions may have the potential to counter age-related cognitive decline. Studies have demonstrated an improvement in age-related cognitive impairment in animals after supplementation with plant extracts containing flavonoids but there are few human studies. This double-blind, controlled study examined the effects on cognitive performance of a 5 week supplementation with Enzogenol Pinus radiata bark extract containing flavonoids, in 42 males aged 50-65 years, with a body mass index >25. Participants were supplemented for 5 weeks either with Enzogenol plus vitamin C, or with vitamin C only. A battery of computerized cognitive tests was administered, and cardiovascular and haematological parameters were assessed prior to and following supplementation. The speed of response for the spatial working memory and immediate recognition tasks improved after supplementation with Enzogenol plus vitamin C, whereas vitamin C alone showed no improvements. A trend in a reduction of systolic blood pressure was observed with Enzogenol plus vitamin C, but not with vitamin C alone. The blood safety parameters were unchanged. The findings suggest a beneficial effect of supplementation with Enzogenol on cognition in older individuals. Larger studies are needed to ascertain its potential as a preventive treatment for age-related cognitive decline.
Measurements of the serum concentrations of the metabolites homocysteine, cystathionine, methylmalonic acid, and 2-methylcitric acid, which accumulates when vitamin B-12-, folate-, and vitamin B-6-dependent enzymatic reactions are impaired, should provide a better indication of intracellular deficiency of these vitamins. We measured the serum concentration of these vitamins and the four metabolites in 99 healthy young people, 64 healthy elderly subjects, and 286 elderly hospitalized patients. A low serum vitamin B-12 concentration was found in 6% and 5%, low folate in 5% and 19%, and low vitamin B-6 in 9% and 51%, and one or more metabolites were elevated in 63% and 83% of healthy elderly subjects and elderly hospitalized patients, respectively. These results strongly suggest that the prevalence of tissue deficiencies of vitamin B-12, folate, and vitamin B-6 as demonstrated by the elevated metabolite concentrations is substantially higher than that estimated by measuring concentrations of the vitamins.
Deficiency of folic acid, vitamin B(6) and/or vitamin B(12) can result in elevated total plasma homocysteine concentrations (tHcy), which are considered to be a risk factor for vascular disease. Studies have shown that supplementation of the three vitamins can lower tHcy even in subjects with tHcy in the normal range.
The aim of this study was to evaluate the effect of a 6 month supplementation with vitamin B(6), B(12) and folate on the concentrations of total plasma homocysteine and serum methylmalonic acid (MMA) of elderly women.
The study was designed as a randomized placebo controlled double-blind trial, and 220 healthy women (aged 60-91 years) were involved. The vitamin and mineral capsule contained pyridoxine (3.4 mg), folic acid (400 microg) and cobalamin (9 microg) in addition to other micronutrients. Blood concentrations of folate, cobalamin, tHcy, MMA and the activity coefficient of erythrocyte alpha-aspartic aminotransferase (alpha-EAST) were measured at baseline and after 6 months of supplementation. Dietary intake was evaluated at the beginning and the end of the intervention by two 3-day diet records.
Median concentrations of serum cobalamin, serum folate and erythrocyte folate increased significantly and tHcy and alpha-EAST activity (indicative of improved status of vitamin B(6)) coefficient decreased significantly in the supplemented group. Median MMA concentration of the supplemented group was significantly lower than that of the placebo group after the intervention. The vitamin supplementation had a greater decreasing effect on the tHcy concentration of volunteers with lower vitamin and higher tHcy initial concentrations. In a linear regression model, baseline tHcy, serum folate, age and alpha-EAST activity coefficient were significantly correlated with the change in tHcy. The change in MMA in the supplement group was significantly associated to the baseline MMA values.
Our results show that a 6 month supplementation including physiological dosages of B vitamins improves the status of these nutrients and reduces tHcy in presumed healthy elderly women.
Our objective was to examine associations among plasma homocysteine concentrations (tHcy), the tHcy-cofactors (folate, vitamins B6 and B12), and multiple domains of cognitive performance, with statistical adjustment for possible confounds, including cardiovascular disease risk factors (CVD-RF) and cardiovascular disease (CVD).
Subjects were 812 participants (58% women) of the Maine-Syracuse study who were free of dementia and stroke. Employing a cross-sectional design and multiple regression analyses, fasting concentrations of tHcy and its vitamin cofactors (folate, B6, and B12) were related to multiple domains of cognitive performance.
With adjustment for age, education, gender, ethnicity, and the vitamins, tHcy was inversely associated with visual-spatial organization, working memory, scanning-tracking, and abstract reasoning. The same results were found with adjustment for age, education, gender, ethnicity, CVD-RF, and CVD. Vitamin cofactors were positively related to cognitive performance, but with adjustment for CVD-RF and CVD, only vitamin B6 was related to multiple cognitive domains.
The inverse association of tHcy with multiple domains of cognitive functioning is not necessarily dependent on vitamin levels, vitamin deficiency, prevalent CVD risk factors, and manifest CVD. Serum folate, serum B12, and plasma B6 vitamin concentrations are positively associated with cognitive performance. Investigation of other possible mechanisms (e.g., tHcy neurotoxicity) mediating tHcy associations with cognitive performance is important, as are clinical trials examining the efficacy of folate, vitamin B6, and vitamin B12 for maintenance of cognitive functioning.
Dietary supplement use is increasingly common in the United States. Multivitamin formulations with or without minerals are typically the most common type of dietary supplement reported in surveys and studies that collect data relating to dietary supplement use. In the National Health and Nutrition Examination Survey (NHANES) 1999-2000, 52% of adults reported taking a dietary supplement in the past month, and 35% reported regular use of a multivitamin-multimineral (MVMM) product. NHANES III data indicate an overall prevalence of dietary supplement usage of 40%, with prevalence rates of 35% in NHANES II and 23% in NHANES I. Women (versus men), older age groups, non-Hispanic whites (versus non-Hispanic blacks or Mexican Americans), and those with a higher education level, lower body mass index, higher physical activity level, and more frequent consumption of wine had a greater likelihood of reporting use of MVMM supplements in NHANES 1999-2000. Data from children suggest a similar prevalence rate, but lower prevalence rates of usage were reported in studies of adolescents. Individuals who use dietary supplements (including MVMM formulations) generally report higher dietary nutrient intakes and healthier diets in studies in which dietary data were also collected. Among adults with a history of breast or prostate cancer, usage rates for dietary supplements in general and MVMMs are considerably higher (eg, 56-57% for MVMMs), and these subgroups are more likely to also report use of single vitamin and mineral supplements. Thus, MVMM use contributes a considerable proportion of nutrient intakes in the United States and may contribute to risk of excessive intakes.
Guaraná (Paullinia cupana) extracts are most commonly used in Western markets as putatively psychoactive food and drink additives. This double-blind, randomised, placebo-controlled, parallel groups study assessed the acute effects of either a vitamin/mineral/guaraná supplement or placebo drink in 129 healthy young adults (18-24 years). Participants completed a 10min version of the Cognitive Demand Battery (comprising: Serial 3s and Serial 7s subtraction tasks, a Rapid Visual Information Processing (RVIP) task, 'mental fatigue' scale). Thirty minutes following their drink participants made six consecutive completions of the battery (i.e. 60 min). The vitamin/mineral/guaraná combination resulted in improved task performance, in comparison to placebo, in terms of both increased speed and accuracy of performing the RVIP task throughout the post-dose assessment. The increase in mental fatigue associated with extended task performance was also attenuated by the supplement. This research supports previous findings demonstrating guaraná's cognition enhancing properties and provides evidence that its addition to a multi-vitamin-mineral supplement can improve cognitive performance and reduce the mental fatigue associated with sustained mental effort.
Herbs and Natural Supplements
- L Braun
- M Cohen
Braun L, Cohen M. 2009. Herbs and Natural Supplements. Chatswood:
NSW, Elsevier.