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Background <p>There is a lack of evidence on microbial compositions and associated metabolic changes in probiotics, prebiotics, or synbiotics (PPS) in older adults.</p> Objective <p>This meta-analysis aims to evaluate the effects of PPS on gut microbiota composition, short-chain fatty acids (SCFAs), and inflammatory markers in older adults.</p> Methods <p>PubMed, Embase, Cochrane Library, and Scopus databases were searched for randomized controlled trials (RCTs) published up to May 2025. RCTs were included if they examined microbiome-related outcomes in individuals aged ≥ 60 years following PPS interventions. The Cochrane Risk of Bias Tool was adopted for Quality appraisal. Meta-analysis was performed in RevMan 5.3, with standardized mean difference (SMD) as effect measures.</p> Results <p>29 RCTs were included, involving 1,633 participants. PPS supplementation notably increased <i>Bifidobacterium</i> abundance (prebiotics: SMD = 1.09; probiotics: SMD = 0.40), whereas synbiotics showed no overall effect but enhanced the abundance of specific strains (B. angulatum, B. longum, B. breve). Probiotic supplementation enhanced microbial diversity (Shannon index: SMD = 0.76), while synbiotics increased <i>Lactobacillus casei</i> abundance (SMD = 0.75) and reduced <i>Pseudomonas</i> levels (SMD = -0.55). For inflammatory markers, prebiotics increased IL-10 levels (SMD = 0.61) and reduced IL-1β (SMD = -0.39), whereas synbiotics reduced TNF-α (SMD = -0.36). Synbiotic supplementation enhanced valeric acid (SMD = 0.50) and acetic acid levels (SMD = 0.62).</p> Conclusion <p>PPS interventions demonstrated potential benefits for older adults by increasing beneficial bacteria such as <i>Bifidobacterium</i> and <i>Lactobacillus casei</i>, reducing harmful genera like <i>Pseudomonas</i>, improving anti-inflammatory responses, and enhancing the production of SCFAs.</p>

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Effects of probiotics, prebiotics, and synbiotics on gut microbiota in older adults: a systematic review and meta-analysis of randomized controlled trials

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月29日

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  • Kai Zhuang,
  • Huanhuan Luo,
  • Muhuang Zeng,
  • Sze Chun Leo CHAN,
  • Meiting Gong,
  • Yunhan Wang

摘要

Background

There is a lack of evidence on microbial compositions and associated metabolic changes in probiotics, prebiotics, or synbiotics (PPS) in older adults.

Objective

This meta-analysis aims to evaluate the effects of PPS on gut microbiota composition, short-chain fatty acids (SCFAs), and inflammatory markers in older adults.

Methods

PubMed, Embase, Cochrane Library, and Scopus databases were searched for randomized controlled trials (RCTs) published up to May 2025. RCTs were included if they examined microbiome-related outcomes in individuals aged ≥ 60 years following PPS interventions. The Cochrane Risk of Bias Tool was adopted for Quality appraisal. Meta-analysis was performed in RevMan 5.3, with standardized mean difference (SMD) as effect measures.

Results

29 RCTs were included, involving 1,633 participants. PPS supplementation notably increased Bifidobacterium abundance (prebiotics: SMD = 1.09; probiotics: SMD = 0.40), whereas synbiotics showed no overall effect but enhanced the abundance of specific strains (B. angulatum, B. longum, B. breve). Probiotic supplementation enhanced microbial diversity (Shannon index: SMD = 0.76), while synbiotics increased Lactobacillus casei abundance (SMD = 0.75) and reduced Pseudomonas levels (SMD = -0.55). For inflammatory markers, prebiotics increased IL-10 levels (SMD = 0.61) and reduced IL-1β (SMD = -0.39), whereas synbiotics reduced TNF-α (SMD = -0.36). Synbiotic supplementation enhanced valeric acid (SMD = 0.50) and acetic acid levels (SMD = 0.62).

Conclusion

PPS interventions demonstrated potential benefits for older adults by increasing beneficial bacteria such as Bifidobacterium and Lactobacillus casei, reducing harmful genera like Pseudomonas, improving anti-inflammatory responses, and enhancing the production of SCFAs.