Cocoa flavanols have shown some benefits for the heart, but they may also be good for cognitive function in older people, researchers found. In a double-blind study, elderly patients with mild cognitive impairment who consumed high or moderate levels of cocoa flavanols for 2 months had significant improvements on certain cognitive assessment tests compared with those who took in only small amounts, Giovambattista Desideri, PhD, of the University of L'Aquila in Italy, and colleagues reported online in Hypertension.

Evidence suggests eating flavonoids, polyphenic compounds from plant-based foods, may confer cardiovascular benefits. Flavonols are a subclass of these compounds that are abundant in tea, grapes, red wine, apples, and cocoa products including chocolate. So to assess whether cocoa flavanols could improve cognitive function in elderly patients with mild cognitive impairment (MCI), Desideri and colleagues assessed 90 elderly patients with MCI who were randomized to drink varying levels of a dairy-based cocoa containing flavanols per day for 8 weeks: 990 mg (high), 520 mg (intermediate), or 45 mg (low).

The researchers found that scores on the Mini Mental State Examination didn't change significantly in any of the groups, a finding that was likely due to the low sensitivity of the test to detect small changes at the upper end of cognitive performance over time, they wrote. There were, however, changes in the time required to complete Trail Making Tests A and B, with significantly greater improvements for those on high or intermediate doses of flavonols compared with those who had a low intake:

  • High: -14.3 seconds for A, -29.2 seconds for B
  • Intermediate: -8.8 seconds for A, -22.8 seconds for B
  • Low: +1.1 second for A, +3.8 seconds for B

Scores on the verbal fluency test improved significantly for all groups, but, improvements were significantly greater for those who had a high versus low intake:

  • High: +8.0 words per 60 seconds
  • Intermediate: +5.1 words per 60 seconds
  • Low: +1.2 words per 60 seconds

Desideri and colleagues also observed improvements in several metabolic parameters, including blood pressure and insulin resistance, for those on high and intermediate doses of cocoa flavanols. The effect on cognition appears to be mediated in part by improvement in insulin sensitivity, the researchers wrote. They noted that there were no changes in cholesterol or triglycerides in any of the groups. The study was limited because its short time-frame didn't allow for conclusions about the extent of cognitive benefits and their duration. Nor can it establish whether the observed benefits are a consequence of the cocoa itself or a secondary effect related to general improvements in cardiovascular function or health. Also, participants were in good health overall and without known cardiovascular disease, so the population may be representative of all subjects with MCI. Still, the researchers concluded that the data "are suggestive of a possible clinical benefit derived from the regular dietary inclusion of cocoa flavanol-containing foods in subjects with MCI."