RCT2022 · AJCN / Alzheimer's & Dementia · Sesso HD, Baker LD et al.
COSMOS: cocoa flavanols –27% cardiovascular death; multivitamin improves memory
Who, how long
21,442 US adults (women 65+, men 60+), 3.6 years; cognitive substudy n=2,262
What they found
500 mg cocoa flavanols: primary endpoint (all CV events) –10%, not significant; CV death –27% (significant). A daily multivitamin (Centrum Silver) improved global cognition by the equivalent of ~2 years of ageing versus placebo (COSMOS-Mind, -Web).
⚠ Caveat
The primary endpoint was missed — mortality is a secondary analysis. The multivitamin effect didn't appear in an earlier large RCT (PHS II). Co-funded by Mars Inc. and Pfizer.
Related in the knowledge base
Last reviewed: 6 September 2026
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