Can a daily multivitamin preserve function in older adults? It may depend on the patient
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Multivitamin use supporting heart health and overall physical function may help maintain the ability to perform everyday activities such as dressing, bathing, walking, climbing stairs, jogging or hurrying, and completing household chores.
—Bayu B. Bekele, PhD, via a press release
A daily multivitamin may modestly improve cardiovascular-related functional health in older adults—but particularly for those with carotid stenosis, according to an analysis of the randomized COSMOS trial being presented at NUTRITION 2026.[]
The findings could help clinicians put a common patient question into perspective: Multivitamins may offer some support for healthy aging, but the average benefit is small and does not replace exercise, a nutritious diet, and evaluation of new functional symptoms.
The CV benefit of daily multivitamin use
COSMOS was a randomized, double-blind, placebo-controlled trial involving 21,442 US adults: Men aged 60 or older and women aged 65 or older.[] Its original analysis found that multivitamin-mineral supplementation did not significantly reduce major cardiovascular events.
For the new analysis, researchers examined annual Kansas City Cardiomyopathy Questionnaire results from 16,027 participants over 3 years.[] Compared with placebo, daily multivitamin use produced small but statistically significant improvements in symptom burden—including fatigue, edema, and dyspnea—and in the combined clinical summary score.
“Multivitamin use supporting heart health and overall physical function may help maintain the ability to perform everyday activities such as dressing, bathing, walking, climbing stairs, jogging or hurrying, and completing household chores,” Bayu B. Bekele, PhD, a postdoctoral fellow at the Georgia Prevention Institute of the Medical College of Georgia at Augusta University, said in a press release.[] “These benefits may be particularly relevant for individuals experiencing fatigue, shortness of breath or swelling in the feet, which can limit daily functioning.”
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Among 122 participants with carotid stenosis, multivitamin use was associated with a 7.58-point improvement in the clinical summary score—large enough to be potentially noticeable to patients.[]
While not yet practice-changing, it could nevertheless justify targeted trials examining whether patients with carotid or other vascular disease benefit more than the general older population.
Cocoa extract did not improve functional health overall.[] Among 238 participants with heart failure, however, it was associated with a 5.62-point improvement in symptom burden. That subgroup result also requires confirmation.
Related: When daily vitamins become a death sentence: What doctors need to knowHow should physicians discuss the findings?
For now, clinicians can reassure patients that a standard multivitamin may be a reasonable, low-risk addition for those with nutritional gaps, restricted diets, or inadequate intake, but evidence remains insufficient to prescribe one specifically to preserve physical function or treat cardiovascular symptoms.
Fatigue, dyspnea, edema, or declining ability to complete daily activities still warrants clinical evaluation. Physicians should also review supplement formulations for unnecessary high-dose nutrients, medication interactions, and duplication with other products.
Because the findings have not yet undergone full peer review, the clinical takeaway remains measured: Daily multivitamin use may modestly support functional health, with a potentially larger benefit in select vascular populations—but it is not yet a functional-health intervention.
Related: Multivitamins, mortality, and longevity: Growing data for the ongoing debate