Skip to main content
SpringerLink
Log in

Can a Prebiotic Formulation Reduce Frailty Levels in Older People?

  • Original Research
  • Trials and Therapeutics
  • Published:
The Journal of Frailty & Aging Aims and scope Submit manuscript

Abstract

Objective

The purpose of this study was to examine whether a prebiotic formulation reduces frailty index (FI) levels in older people.

Design

We conducted secondary analysis of a placebo-controlled, randomized, double-blind design study.

Setting/Participants

The study included non-demented people over the age of 65 who were living in nursing homes and were able to walk. Fifty participants completed the study (75.3±7.3 years, 70% females).

Intervention

Participants were randomly assigned to either a group who received daily Darmocare Pre® (inulin and fructooligosaccharides) for 13 weeks or a placebo group (maltodextrin).

Measurement

The primary outcome in this secondary analysis was change in level of a 62-item FI compared to baseline.

Results

At the 13-week follow-up, the placebo group had higher FI levels (preFI 0.23±0.11, postFI 0.24±0.12, p=0.012) and the intervention group had lower FI levels (preFI 0.22±0.09, postFI 0.20±0.08, p<0.001). There was an average increase of 0.01±0.01 in the FI score in the placebo group (0.4 deficits; Cohen’s d 0.61; standardized response mean 0.59) and an average reduction of 0.02±0.02 in the intervention group (1.1 deficits; Cohen’s d -1.35; standardized response mean -1.16). Among the 28 participants in the intervention group, FI levels were reduced for 25 people; five of them had an FI reduction greater than 0.03. The moderately/severely frail participants (FI >0.3, N=5) had the greatest reduction in their FI (0.04±0.01).

Conclusion

A prebiotic intervention can reduce frailty levels in nursing home residents especially in those with higher levels of frailty.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2

Similar content being viewed by others

Abbreviations

FI:

frailty index

FOS:

fructooligosaccharides

References

  1. O’Hara AM, Shanahan F. The gut flora as a forgotten organ. EMBO J. 2006;7:688–693.

    Article  CAS  Google Scholar 

  2. Feng Q, Chen WD, Wang YD. Gut Microbiota: An Integral Moderator in Health and Disease. Front Microbiol. 2018 Feb 21;9:151. doi: 10.3389/fmicb.2018.00151.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Wang B, Yao M, Lv L, Ling Z, Li L. The Human Microbiota in Health and Disease. Engineering. 2017 Feb;3(1):71–82.

    Article  Google Scholar 

  4. Zwielehner J, Liszt K, Handschur M, Lassl C, Lapin A, Haslberger AG. Combined PCR-DGGE fingerprinting and quantitative-PCR indicates shifts in fecal population sizes and diversity of Bacteroides, bifidobacteria and Clostridium cluster IV in institutionalized elderly. Exp Gerontol. 2009 Jun-Jul;44(6-7):440–446. doi: 10.1016/j. exger.2009.04.002.

    Article  CAS  PubMed  Google Scholar 

  5. Jeffery IB, Lynch DB, O’Toole PW. Composition and temporal stability of the gut microbiota in older persons. ISME J. 2016 Jan;10(1):170–182.

    Article  CAS  PubMed  Google Scholar 

  6. Grosicki GJ, Fielding RA, Lustgarten MS. Gut Microbiota Contribute to Age-Related Changes in Skeletal Muscle Size, Composition, and Function: Biological Basis for a Gut-Muscle Axis. Calcif Tissue Int. 2018 Apr;102(4):433–432.

    Article  CAS  PubMed  Google Scholar 

  7. García-Peña C, Álvarez-Cisneros T, Quiroz-Baez R, Friedland RP. Microbiota and Aging. A Review and Commentary. Arch Med Res. 2017 Dec 8. pii: S0188-4409(17)30234-5. doi: 10.1016/j.arcmed.2017.11.005.

    Google Scholar 

  8. Jackson MA, Jeffery IB, Beaumont M, Bell JT, Clark AG, Ley RE, O’Toole PW, Spector TD, Steves CJ. Signatures of early frailty in the gut microbiota. Genome Med. 2016 Jan 29;8(1):8. doi: 10.1186/s13073-016-0262-7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. La Fata G, Rastall RA, Lacroix C, Harmsen HJM, Mohajeri MH, Weber P, et al. Recent Development of Prebiotic Research-Statement from an Expert Workshop. Nutrients. 2017 Dec 20;9(12). pii: E1376. doi: 10.3390/nu9121376.

    Google Scholar 

  10. Slavin J. Fiber and prebiotics: mechanisms and health benefits. Nutrients. 2013 Apr 22;5(4):1417–1435. doi: 10.3390/nu5041417.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Kathy R. Niness; Inulin and Oligofructose: What Are They? The Journal of Nutrition. 1999 July;129(7):1402S–1406S. https://doi.org/10.1093/jn/129.7.1402S

    Article  Google Scholar 

  12. Salazar N, Valdés-Varela L, González S, Gueimonde M, de Los Reyes-Gavilán CG. Nutrition and the gut microbiome in the elderly. Gut Microbes. 2017 Mar 4;8(2):82–97. doi: 10.1080/19490976.2016.1256525.

    Article  CAS  PubMed  Google Scholar 

  13. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013 Mar 2;381(9868):752–762. doi: 10.1016/S0140-6736(12)62167-9.

    Article  PubMed  Google Scholar 

  14. Buigues C, Fernández-Garrido J, Pruimboom L, Hoogland AJ, Navarro-Martínez R, Martínez-Martínez M, et al. Effect of a Prebiotic Formulation on Frailty Syndrome: A Randomized, Double-Blind Clinical Trial. Int J Mol Sci. 2016 Jun 14;17(6). pii: E932. doi: 10.3390/ijms17060932.

    Article  CAS  PubMed  Google Scholar 

  15. de Vries NM, Staal JB, van Ravensberg CD, Hobbelen JS, Olde Rikkert MG, Nijhuisvan der Sanden MW. Outcome instruments to measure frailty: a systematic review. Ageing Res Rev. 2011;10(1):104–114.

    Article  PubMed  Google Scholar 

  16. Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World Journal. 2001 Aug 8;1:323–336.

    Article  CAS  PubMed  Google Scholar 

  17. Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K. A standard procedure for creating a frailty index. BMC Geriatr. 2008 Sep 30;8:24.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Rutenberg AD, Mitnitski AB, Farrell SG, Rockwood K. Unifying aging and frailty through complex dynamical networks. Exp Gerontol. 2017 Aug 25. pii: S0531-5565(17)30482-5. doi:10.1016/j.exger.2017.08.027.

    Google Scholar 

  19. Theou O, Brothers TD, Peña FG, Mitnitski A, Rockwood K. Identifying common characteristics of frailty across seven scales. J Am Geriatr Soc. 2014 May;62(5):901–906. doi: 10.1111/jgs.12773

    Article  PubMed  Google Scholar 

  20. Blodgett JM, Theou O, Howlett SE, Rockwood K. A frailty index from common clinical and laboratory tests predicts increased risk of death across the life course. Geroscience. 2017 Sep 2. doi: 10.1007/s11357-017-9993-7.

    Google Scholar 

  21. Theou O, Blodgett JM, Godin J, Rockwood K. Association between sedentary time and mortality across levels of frailty. CMAJ. 2017 Aug 21;189(33):E1056–E1064. doi: 10.1503/cmaj.161034.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Eendebak RJAH, Theou O, van der Valk A, Godin J, Rockwood K. Defining clinically important differences in frailty: results from community-dwelling people and Emergency Department patients. Canadian Geriatrics Journal (accepted)

  23. Mitnitski A, Rockwood K. The rate of aging: the rate of deficit accumulation does not change over the adult life span. Biogerontology. 2016;17(1):199–204. doi: 10.1007/s10522-015-9583-y

    Article  PubMed  Google Scholar 

  24. Apóstolo J, Cooke R, Bobrowicz-Campos E, et al. Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: a systematic review. JBI Database System Rev Implement Rep. 2018 Jan;16(1):140–232.

  25. Moroti C, Souza Magri LF, de Rezende Costa M, Cavallini DC, Sivieri K. Effect of the consumption of a new symbiotic shake on glycemia and cholesterol levels in elderly people with type 2 diabetes mellitus. Lipids Health Dis. 2012 Feb 22;11:29. doi: 10.1186/1476-511X-11-29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Abizanda P, López MD, García VP, et al. Effects of an Oral Nutritional Supplementation Plus Physical Exercise Intervention on the Physical Function, Nutritional Status, and Quality of Life in Frail Institutionalized Older Adults: The ACTIVNES Study. J Am Med Dir Assoc. 2015 May 1;16(5):439.e9-439.e16.

    Article  PubMed  Google Scholar 

  27. Sasaki D, Sasaki K, Ikuta N, Yasuda T, Fukuda I, Kondo A, Osawa R. Low amounts of dietary fibre increase in vitro production of short-chain fatty acids without changing human colonic microbiota structure. Sci Rep. 2018 Jan 11;8(1):435.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. van der Beek CM, Canfora EE, Kip AM, Gorissen SHM, Olde Damink SWM, van Eijk HM, et al. The Prebiotic Inulin Improves Substrate Metabolism and Promotes Short-Chain Fatty Acid Production in Overweight to Obese Men. Metabolism. 2018 Jun 25. pii: S0026-0495(18)30151-3. doi: 10.1016/j.metabol.2018.06.009.

    Google Scholar 

  29. Theou O, Rockwood MR, Mitnitski A, Rockwood K. Disability and co-morbidity in relation to frailty: how much do they overlap? Arch Gerontol Geriatr. 2012 Sep-Oct;55(2):e1–8

    Article  PubMed  Google Scholar 

  30. Farrell S, Mitnitski A, Theou O, Rockwood K, Rutenberg A. Probing the network structure of health deficits in human aging. 2018 arXiv:1802.08708 [q-bio.PE]

    Google Scholar 

  31. Theou O, Chapman I, Wijeyaratne L, et al. Can an Intervention with Testosterone and Nutritional Supplement Improve the Frailty Level of Under-Nourished Older People? J Frailty Aging. 2016;5(4):247–252.

    CAS  PubMed  Google Scholar 

  32. Langille MG, Meehan CJ, Koenig JE, et al. Microbial shifts in the aging mouse gut. Microbiome. 2014 Dec 5;2(1):50. doi: 10.1186/s40168-014-0050-9.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Dalhousie University and Nova Scotia Health Authority, Halifax, Canada

    Olga Theou, K. Jayanama & K. Rockwood

  2. Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

    K. Jayanama

  3. Department of Nursing, University of Valencia, Valencia, Spain

    J. Fernández-Garrido, C. Buigues, R. Navarro-Martínez & O. Cauli

  4. Natura Foundation, Numansdorp, 3281 NC, The Netherlands

    L. Pruimboom

  5. University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands

    L. Pruimboom

  6. Bonusan BV, Numansdorp, The Netherlands

    A. J. Hoogland

  7. Rm 1313, Veterans’ Memorial Building, 5955 Veterans’ Memorial Lane, Halifax, Nova Scotia, B3H2E1, Canada

    Olga Theou

Authors
  1. Olga Theou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Jayanama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Fernández-Garrido
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Buigues
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Pruimboom
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. J. Hoogland
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. R. Navarro-Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. K. Rockwood
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. O. Cauli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Olga Theou.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Theou, O., Jayanama, K., Fernández-Garrido, J. et al. Can a Prebiotic Formulation Reduce Frailty Levels in Older People?. J Frailty Aging 8, 48–52 (2019). https://doi.org/10.14283/jfa.2018.39

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.14283/jfa.2018.39

Keywords

Search

Navigation