The Effect of a Prebiotic Supplement on Frailty in Older Adults

by | Nov 26, 2024 | 2024, Aging, Probiotics, Recent Articles

Written by Harold Oster, MD. A prebiotic supplement may improve measures of frailty in older adults.

elderly woman with caregiverFrailty is usually defined as an age-related decline in function and reserve that reduces the ability to cope with external stressors. It is associated with an increased risk of depression, injury, disability, and mortality. The underlying cause of frailty is unknown, although chronic inflammation may contribute1. The gut microbiome plays an important role in human health, influencing the risk of chronic inflammation and numerous diseases, including diabetes, cardiovascular disease, and dementia2. Prebiotics are non-digestible food ingredients that support the growth of healthy intestinal bacterial, improving the microbiome3.

Jie Yang et al. studied the effects of a prebiotic supplement on intestinal bacterial flora and measures of frailty in older individuals. The authors recruited 1,693 community-dwelling adults over 65 years old and divided them into normal, pre-frail, and frail groups based on the Fried Frailty Index4. One hundred randomly chosen participants in each group were evaluated for social, demographic, and lifestyle factors, blood chemistries, and the intestinal microbiome. The members of the pre-frail and frail groups were randomized to receive a prebiotic mixture of inulin and oligofructose5 or a maltodextrin placebo daily for three months. At the end of the intervention, they were evaluated for frailty status, blood tests, and intestinal flora.

The authors noted the following:

  • The prevalence of frailty was 16.8% (16.7% of men and 16.9% of women)
  • The prevalence of prefrailty was 41.6% (53.4% of men and 33.0% of women)
  • Frail participants were older, more likely to have medical comorbidities, and less likely to exercise regularly than participants who were not frail.
  • In both the prefrail and frail groups, the frailty index improved in those who received the prebiotic mixture.
  • Grip strength and walking speed improved in the frail participants who received the prebiotic supplement.
  • Those in the prefrail group who received the prebiotic mixture improved in the exhaustion component of the frailty index.
  • No consistent differences in tests of kidney function, liver disease, or inflammation were noted between the placebo and intervention groups.
  • In both the prefrail and frail groups, those who received the prebiotic supplement had increased levels of beneficial bacteria. In the frail group, those who received the prebiotic had an increased level of E. coli, a pathogenic bacteria.
  • No significant side effects of the prebiotic mixture were noted.

Results suggest that a prebiotic supplement may improve measures of frailty in older adults. Limitations include possible residual confounding and the possibility that maltodextrin in the placebo affected the microbiome6.

Source: Yang, Jie, Liming Hou, Anhui Wang, Lei Shang, Xin Jia, Rong Xu, and Xiaoming Wang. “Prebiotics improve frailty status in community-dwelling older individuals in a double-blind, randomized, controlled trial.” Journal of Clinical Investigation 134, no. 18 (2024): e176507.

© 2024, Yang et al. This is an open access article published under the terms of the Creative Commons Attribution 4.0 International License.

Click here to read the full text study.

Posted November 26, 2024.

Harold Oster, MD graduated from medical school in Miami, Florida in 1992 and moved to Minnesota in 2004. After more than 25 years of practicing Internal Medicine, he recently retired. Dr. Oster is especially interested in nutrition, weight management, and disease prevention. Visit his website at haroldoster.com.

References:

  1. Soysal P, Stubbs B, Lucato P, et al. Inflammation and frailty in the elderly: A systematic review and meta-analysis. Ageing Res Rev. Nov 2016;31:1-8. doi:10.1016/j.arr.2016.08.006
  2. Hills RD, Jr., Pontefract BA, Mishcon HR, Black CA, Sutton SC, Theberge CR. Gut Microbiome: Profound Implications for Diet and Disease. Nutrients. Jul 16 2019;11(7)doi:10.3390/nu11071613
  3. Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Definition, Types, Sources, Mechanisms, and Clinical Applications. Foods. Mar 9 2019;8(3)doi:10.3390/foods8030092
  4. Dent E, Kowal P, Hoogendijk EO. Frailty measurement in research and clinical practice: A review. Eur J Intern Med. Jun 2016;31:3-10. doi:10.1016/j.ejim.2016.03.007
  5. Kolida S, Tuohy K, Gibson GR. Prebiotic effects of inulin and oligofructose. Br J Nutr. May 2002;87 Suppl 2:S193-7. doi:10.1079/bjnbjn/2002537
  6. Almutairi R, Basson AR, Wearsh P, Cominelli F, Rodriguez-Palacios A. Validity of food additive maltodextrin as placebo and effects on human gut physiology: systematic review of placebo-controlled clinical trials. Eur J Nutr. Sep 2022;61(6):2853-2871. doi:10.1007/s00394-022-02802-5

 

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