Wen Na-Na, Sun Li-Wei, Geng Qian, Zheng Guo-Hua
College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China.
Graduate School, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
World J Clin Cases. 2024 Dec 16;12(35):6815-6825. doi: 10.12998/wjcc.v12.i35.6815.
Frailty is a complex aging-related syndrome characterized by a cumulative loss of physiological reserve and increased vulnerability to adverse clinical outcomes, including falls, disability, incapacity and death. While an increasing number of studies suggest that the gut microbiota may play a key role in the pathophysiology of frailty, direct evaluation of the association between gut microbiome alterations and frailty in older adults remains limited.
To gain insight into gut dysbiosis in frail older adults.
Seven electronic databases (China National Knowledge Infrastructure, VIP, SinoMed, Wanfang, PubMed, Web of Science and EMBASE) were searched for articles published before October 31, 2023 to identify observational studies that compared the microbiomes of older adults with and without frailty. The diversity and composition of the gut microbiota were the main outcomes used to analyze the associations of changes in the gut microbiota with frailty in older adults. The quality of the included studies was assessed the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality.
Eleven observational studies with 912 older adults were included in this review. Consistent results revealed a significant difference in the gut microbiota composition between frail and non-frail older adults, with a significant decrease in α diversity and a significant increase in β diversity in frail older adults. The pooled results revealed that at the phylum level, four microbiota (, , and ) were significantly enriched, and two microbiota ( and ) were significantly depleted in frail older adults. At the family level, the results consistently revealed that the abundances of 6 families, most of which belong to the or phylum, were greater in frail than in non-frail older adults. At the genus or species level, consistent results from more than two studies revealed that the abundances of the genera , and were significantly lower in frail older adults; individual studies revealed that the abundances of some genera or species (, , , and ) were significantly lower, whereas those of other genera or species (, , , and ) were significantly greater in frail older adults.
This systematic review suggests that changes in the gut microbiota are associated with frailty in older adults, which is commonly reflected by a reduction in beneficial species and an increase in pathogenic species. However, further studies are needed to confirm these findings.
衰弱是一种与衰老相关的复杂综合征，其特征是生理储备的累积丧失以及对不良临床结局（包括跌倒、残疾、失能和死亡）的易感性增加。虽然越来越多的研究表明肠道微生物群可能在衰弱的病理生理学中起关键作用，但对老年人肠道微生物群改变与衰弱之间关联的直接评估仍然有限。
深入了解衰弱老年人的肠道菌群失调情况。
检索了七个电子数据库（中国知网、维普、万方、PubMed、Web of Science和EMBASE）中2023年10月31日前发表的文章，以识别比较有和没有衰弱的老年人微生物群的观察性研究。肠道微生物群的多样性和组成是用于分析老年人肠道微生物群变化与衰弱之间关联的主要结果。纳入研究的质量采用纽卡斯尔-渥太华量表和医疗保健研究与质量局进行评估。
本综述纳入了11项观察性研究，共912名老年人。一致的结果显示，衰弱和非衰弱老年人的肠道微生物群组成存在显著差异，衰弱老年人的α多样性显著降低，β多样性显著增加。汇总结果显示，在门水平上，衰弱老年人中有四种微生物群（、、和）显著富集，两种微生物群（和）显著减少。在科水平上，结果一致显示，衰弱老年人中6个科的丰度高于非衰弱老年人，其中大多数属于或门。在属或种水平上，两项以上研究的一致结果显示，衰弱老年人中属、和的丰度显著较低；个别研究显示，衰弱老年人中一些属或种（、、、和）的丰度显著较低，而其他属或种（、、、和）的丰度显著较高。
本系统综述表明，肠道微生物群的变化与老年人的衰弱有关，这通常表现为有益菌种减少和致病菌种增加。然而，需要进一步的研究来证实这些发现。
