Can probiotics, prebiotics and synbiotics improve functional outcomes for older people: a systematic review
Can probiotics, prebiotics and synbiotics improve functional outcomes for older people: a systematic review
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.
Functional outcomes, Older, Prebiotics, Probiotics, Synbiotics
975-993
Coutts, L.
2736f147-abdd-40e5-8393-b7b27fc0ca52
Ibrahim, K.
54f027ad-0599-4dd4-bdbf-b9307841a294
Tan, Q.Y.
1fc61c34-8117-42e1-b333-0cedc999be1a
Lim, S.E.R.
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Cox, N.J.
dfdfbc5f-41b8-4329-a4b5-87b6e93aa09e
Roberts, H.C.
5ea688b1-ef7a-4173-9da0-26290e18f253
December 2020
Coutts, L.
2736f147-abdd-40e5-8393-b7b27fc0ca52
Ibrahim, K.
54f027ad-0599-4dd4-bdbf-b9307841a294
Tan, Q.Y.
1fc61c34-8117-42e1-b333-0cedc999be1a
Lim, S.E.R.
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Cox, N.J.
dfdfbc5f-41b8-4329-a4b5-87b6e93aa09e
Roberts, H.C.
5ea688b1-ef7a-4173-9da0-26290e18f253
Coutts, L., Ibrahim, K., Tan, Q.Y., Lim, S.E.R., Cox, N.J. and Roberts, H.C.
(2020)
Can probiotics, prebiotics and synbiotics improve functional outcomes for older people: a systematic review.
European Geriatric Medicine, 11 (6), .
(doi:10.1007/s41999-020-00396-x).
Abstract
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.
Text
s41999-020-00396-x
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More information
Accepted/In Press date: 9 September 2020
e-pub ahead of print date: 24 September 2020
Published date: December 2020
Additional Information:
Funding Information: the National Institute for Health Research (NIHR) funded this research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. LC, QYT and NJC were supported by the University of Southampton NIHR Academic Clinical Fellowship Scheme. SERL is supported by the NIHR Academic Clinical Lectureship Scheme. NJC and HCR receive support from the NIHR Southampton Biomedical Research Centre. HCR, KI and SERL receive support from the NIHR Applied Research Collaboration: Wessex.
Keywords:
Functional outcomes, Older, Prebiotics, Probiotics, Synbiotics
Identifiers
Local EPrints ID: 444851
URI: http://eprints.soton.ac.uk/id/eprint/444851
ISSN: 1878-7649
PURE UUID: 08c38d51-57f3-40ec-bb61-3aca5d70accb
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Date deposited: 06 Nov 2020 17:32
Last modified: 24 Apr 2024 02:10
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Author:
L. Coutts
Author:
Q.Y. Tan
Author:
N.J. Cox
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