Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Ctra. Sacramento s/n, La Cañada, 04120 Almería, Spain.
Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Ctra. Sacramento s/n, La Cañada, 04120 Almería, Spain; Health Research Center, University of Almería, Spain; Health Sciences Research Group (CTS-451), University of Almería, Spain.
Prog Neuropsychopharmacol Biol Psychiatry. 2021 Jun 8;108:110189. doi: 10.1016/j.pnpbp.2020.110189. Epub 2020 Dec 5.
Dementia is a chronic syndrome characterized by cognitive and behavioral symptoms, which may include short-term memory impairment and problems related to orientation, language, attention and perception. Although cognitive impairment (CI) is increasingly considered the main geriatric condition predisposing to dementia, its early management could still promote symptomatic relief and delay disease progression. Recently, probiotics treatment has been studied as a potential new therapeutic approach to attenuate dementia-related decline and mild cognitive impairment (MCI). Therefore, we conducted a systematic review and meta-analysis to review and analyse the available evidence on the effect of probiotics on MCI and dementia.
A systematic search and meta-analysis were performed on Cochrane Library, ProQuest, Web of Science, PubMed-Medline, The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, ScienceDirect and Open Grey. Search terms included diagnoses of interest (dementia and MCI) and the intervention of interest (probiotic, lactobacillus and bifidobacterium). Original articles reporting the use of probiotics supplementation for the treatment of dementia and MCI were screened and studied independently by two researchers. After that, a random and fixed effects model was used at the meta-analysis stage of the results to determine its effect size.
A total of 16 articles (10 preclinical and 6 clinical) that met the inclusion criteria for the systematic review, and 15 articles (10 preclinical and 5 clinical) for meta-analysis were finally included. In humans, the administration of probiotics improved general cognitive function after the treatment period. Similarly, an improvement in memory and spatial/non-spatial learning was identified in the probiotic group of animals compared to the control group. On the other hand, the results showed an increase in the levels of the brain-derived neurotrophic factor, an improvement in the inflammatory profile and regulation of cellular biomarkers after probiotics administration.
Probiotics supplementation could be an adequate therapeutic strategy both in dementia and CI based on clinical and preclinical evidence. However, it is therefore important to translate preclinical data into clinical data where the evidence is more limited.
痴呆症是一种以认知和行为症状为特征的慢性综合征，可能包括短期记忆障碍以及与定向、语言、注意力和感知相关的问题。尽管认知障碍（CI）越来越被认为是导致痴呆症的主要老年病，但对其进行早期管理仍可促进症状缓解并延缓疾病进展。最近，益生菌治疗已被研究为一种潜在的新治疗方法，以减轻与痴呆相关的衰退和轻度认知障碍（MCI）。因此，我们进行了系统评价和荟萃分析，以回顾和分析益生菌对 MCI 和痴呆症影响的现有证据。
我们在 Cochrane 图书馆、ProQuest、Web of Science、PubMed-Medline、护理与健康相关文献累积索引（CINAHL）、Scopus、ScienceDirect 和 Open Grey 上进行了系统搜索和荟萃分析。搜索术语包括感兴趣的诊断（痴呆症和 MCI）和感兴趣的干预措施（益生菌、乳酸菌和双歧杆菌）。两名研究人员独立筛选并研究了报告使用益生菌补充剂治疗痴呆症和 MCI 的原始文章。之后，在结果的荟萃分析阶段使用随机和固定效应模型来确定其效应大小。
共有 16 篇文章（10 篇临床前和 6 篇临床）符合系统评价的纳入标准，最终纳入了 15 篇文章（10 篇临床前和 5 篇临床）进行荟萃分析。在人类中，益生菌治疗后可改善治疗期间的整体认知功能。同样，与对照组相比，动物益生菌组的记忆和空间/非空间学习也得到了改善。另一方面，结果显示益生菌治疗后脑源性神经营养因子水平升高，炎症谱改善，细胞生物标志物得到调节。
基于临床前和临床证据，益生菌补充剂可能是痴呆症和 CI 的一种合适的治疗策略。然而，因此，将临床前数据转化为证据更有限的临床数据非常重要。
