Can probiotics, prebiotics and synbiotics improve functional outcomes for older people: a systematic review
Open accessAbstract
Purpose: Research evaluating the effect of probiotics, prebiotics and synbiotics (PPS) on laboratory markers of health (such as immunomodulatory and microbiota changes) is growing but it is unclear whether these markers translate to improved functional outcomes in the older population. This systematic review evaluates the effect of PPS on functional outcomes in older people. Methods: We conducted a systematic review of the effect of PPS in older adults on functional outcomes (physical strength, frailty, mood and cognition, mortality and receipt of care). Four electronic databases were searched for studies published since year 2000. Results: Eighteen studies (including 15 RCTs) were identified. One of five studies evaluating physical function reported benefit (improved grip strength). Two analyses of one prebiotic RCT assessed frailty by different methods with mixed results. Four studies evaluated mood with no benefit reported. Six studies evaluated cognition: four reported cognitive improvement in participants with pre-existing cognitive impairment receiving probiotics. Seven studies reported mortality as a secondary outcome with a trend to reduction in only one. Five studies reported length of hospital stay but only two peri-operative studies reported shorter stays. Conclusion: There is limited evidence that probiotics may improve cognition in older people with pre-existing cognitive impairment but no clear evidence of benefit of PPS on physical function, frailty, mood, length of hospitalisation and mortality. Larger studies with more homogenous interventions, accounting for confounding factors, such as diet, co-morbidities and medications, are required. There is currently inadequate evidence to recommend PPS use to older people in general. PROSPERO registration number: PROSPERO registration number is CRD42020173417. Date of PROSPERO registration: 01/05/20.
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There is some evidence for improved cognition with probiotic use in those with pre-existing cognitive impairment.
“There is some evidence for improved cognition with probiotic use in those with pre-existing cognitive impairment [31]”
From Fecal microbiota transfer between young and aged mice reverses hallmarks of the aging gut, eye, and brain (2022) · cites this paper as [31]
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- Authors
- Coutts, L., Ibrahim, K., Tan, Q. Y., Lim, S. E. R., Cox, N. J., & Roberts, H. C.
- Affiliations
- Southampton General Hospital (GB)
- Corresponding author
- Coutts, L.
- Venue
- European Geriatric Medicine
- Published
- 2020-09-24
- Volume
- 11
- Issue
- 6
- Pages
- 975-993
- ISSN
- 1878-7649 (ISSN-L)
- 1878-7657
- PMC
- PMC7515554
- OpenAlex
- W3088960136
- Cited by
- 33
- References
- 45
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 11 · 2023: 2 · 2022: 8 · 2021: 4
- FWCI
- 0.30
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Geriatric Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion, cc-by)
- Funders
- National Institute for Health Research
- University of Southampton
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Microbial Metabolites in Food Biotechnology
- Keywords
- probiotics, prebiotics, synbiotics, older adults, functional outcome, physical function, grip strength, frailty, cognitive impairment, mood, mortality, length of hospital stay, gut microbiota, immunomodulation
- MeSH terms
- Aged, Cognition, Humans, Probiotics, Prebiotics, Synbiotics
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