Probiotics for Mild Cognitive Impairment and Alzheimer’s Disease: A Systematic Review and Meta-Analysis

Foods
Q1
Jul 2021
Citations:68
Influential Citations:6
Systematic Reviews / Meta-Analyses
90
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Methods
Eight randomized, double-blind, placebo-controlled trials in individuals with Alzheimer's disease (AD) or mild cognitive impairment (MCI); participants aged 50–90 years; total N = 174 AD and 446 MCI; studies conducted in Iran, Korea, Japan, USA, and Brazil.
Intervention
Daily probiotic (≥1×10^9 CFU) or synbiotic regimens for ~12 weeks (mostly 12 weeks; some 90 days or 16 weeks); delivery forms included encapsulated probiotics, probiotic-enriched pasteurized milk, and Kefir grain synbiotic; includes Lactobacillus rhamnosus GG, Lactobacillus spp., Bifidobacterium spp., and DW2009.
Results
Probiotic and synbiotic supplementation improved cognitive function, with a significant effect in MCI and a modest effect in AD; overall results showed high heterogeneity; benefits were more pronounced with multiple strains, higher doses, longer duration, and earlier disease stage; therefore probiotics may improve cognitive function in MCI or AD, but evidence is insufficient and longer-term, large-scale trials are needed to confirm and optimize regimens.
Limitations
Some trials had small sample sizes; substantial heterogeneity across included studies due to differences in strains, dosages, durations, and disease stage; varied cognitive outcome measures; inconsistent diagnostic criteria; potential confounding from concurrent lifestyle/diet; incomplete reporting of adverse events; some studies lacked full blinding/outcome assessment details; limited data on gut microbiota changes; potential publication bias.

Abstract

Accumulating evidence from animal studies supports the potential role of probiotics and prebiotics in alleviating neurodegenerative diseases. However, whether dietary supplementation with probiotics improves cognitive function in patients with Alzhei...