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Intestinal microbiome in normal ageing, frailty and cognition decline

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MCO.0000000000000878

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ageing; frailty; gut-brain axis; interventions; microbiota

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The intestinal microbiome plays a role in the risk of age-related chronic diseases and syndromes in older individuals, including frailty and neurodegenerative diseases. Recent research suggests that the diversity and composition of gut microbiota are associated with physical and cognitive performance in older age. Targeting the microbiota may be a potential intervention for healthy aging.
Purpose of reviewThe intestinal microbiome modulates the risk of several age-related chronic diseases and syndromes, including frailty and neurodegenerative diseases. Herein we provided an update on the influence of gut microbiota on physical and cognitive performance in older age and suggest microbiota-targeted interventions for healthy ageing.Recent findingsLow uniqueness index of the gut microbiome and high representation of Bacteroides are independently associated with mortality in older individuals, while the centenarian microbiome is characterized by high abundance of Lactobacilli and Bifidobacteria. Frailty syndrome, sarcopenia and cognitive decline are associated with reduced faecal microbiota biodiversity, reduced abundance of bacteria able to synthetize short-chain fatty acids (SCFA), including Faecalibacterium prausnitzii, and reduced faecal butyrate levels. Dietary intervention, especially involving Mediterranean diet, and exercise training seem to be associated with improved biodiversity of the microbiota, increased capacity of SCFA synthesis and, probably, protection against the onset of frailty and cognitive decline.The gut microbiota biodiversity and composition may reflect the different ageing trajectory, but further research is needed to understand potential independent and combined effects of environmental and lifestyle factors in older adults, especially from a clinical point of view.

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