Importance of using probiotics in modulating the intestinal microbiota for cognitive improvement in patients with Alzheimer's
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Jun 4, 2025
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Abstract
Objective: To evaluate the effects of probiotics on microbiota modulation in patients with Alzheimer's disease. Methods: An integrative review was conducted based on the question “What are the benefits of probiotics on microbiota modulation in patients with AD?”. The research included full articles published between 2015 and 2025, in Portuguese and English, in the BVS, EMBASE, CAPES and PubMed databases. Ten studies were categorized by year, title, journal and database for detailed analysis. Results: Ten articles were obtained, of which 60% were published in A1 journals, 100% were published in English, and 30% included randomized clinical trials. In addition, 100% of the studies addressed the benefits of probiotics in cognitive domains. Modulation of the intestinal microbiota by probiotics demonstrated a positive impact on cognition. These results reinforce the gut-brain axis theory, where changes in the microbiota influence cognitive function. In addition, probiotics may help control inflammation and maintain neurochemical balance, essential processes in the context of AD. Final considerations: Probiotic supplementation shows promise in modulating the microbiota of patients with AD, with beneficial effects on cognition and quality of life.
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GuedesK. da C. R. de S., NogueiraT. B. de S. de S., & NogueiraR. B. de S. de S. (2025). Importance of using probiotics in modulating the intestinal microbiota for cognitive improvement in patients with Alzheimer’s. Revista Eletrônica Acervo Científico, 25, e20565. https://doi.org/10.25248/reac.e20565.2025
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References
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27. NAGPAL R, et al. Modified Mediterranean-ketogenic diet modulates gut microbiome and short-chain fatty acids in association with Alzheimer's disease markers in subjects with mild cognitive impairment. EBioMedicine. 2019, 47(1):529-542.
28. NGANDU T, et al. Uma intervenção multidomínio de 2 anos de dieta, exercício, treinamento cognitivo e monitoramento de risco vascular versus controle para prevenir o declínio cognitivo em idosos em risco (FINGER): um ensaio clínico randomizado. Lancet. 2015, 385(1): 2255–2263.
29. PARK Q, et al. Bidirectional regulatory potentials of short-chain fatty acids and their G-protein-coupled receptors in autoimmune neuroinflammation. Scientific Reports. 2019, 9(9):78-85
30. PATEL V, et al. Déficit global do metabolismo energético no cérebro com doença de Alzheimer. Revista de prevenção da doença de Alzheimer. 2024, 11(1): 171-178
31. RAYANNE P, et al. Atenção Farmacêutica Na Doença de Alzheimer. Research, Society and Development. 2021, 10, (13): 1-9.
32. REN ZL, et al. Causal relationships between gut microbiota and dementia: A two-sample, bidirectional, Mendelian randomization study. World Journal Clinical Cases. 2022;12(16):2780-2788.
33. SINGH R. et al. Influence of diet on the gut microbiome andimplications for human health. Journal of Translational Medicine. 2017, 15(73): 15–29.
34. SOUZA TT, et al. Promoção em saúde mental de adolescentes em países da América Latina: uma revisão integrativa da literatura. Ciência e Saúde Coletiva. 2021, 26(7): 2575-2586.
35. STRASSER B et al. Probiotic supplements beneficially affect tryptophan-kynurenine metabolism and reduce the incidence of upper respiratory tract infections in trained athletes: a randomized, double blinded, placebo-controlled trial. Nutrients. 2016, 8(11): e7522016
36. TCHEKALAROVA J, TZONEVA R. Oxidative Stress and Aging as Risk Factors for Alzheimer’s Disease and Parkinson’s Disease: The Role of the Antioxidant Melatonin. International Journal of Molecular Sciences. 2023, 24(3): 3022-3046.
37. TSAI YC, et al. Gerobiotics: probiotics targeting fundamental aging processes. Bioscience of Microbiota, Food and Health. 2021, 40(1): 1–11.
38. XI C, et al. Can early gut microbiota screening reduce the incidence of cognitive impairment? A Mendelian randomization study. Journal of Alzheimer’s Disease. 2024, 102(1): 195-206.
39. ZHAO Q, et al. Evaluating Causal Effects of Gut Microbiome on Alzheimer's Disease. The Journal of Prevention of Alzheimer's Disease. 2024, 11(6): 1843-1848
2. AKBARI E, et al. Efeito da suplementação de probióticos na função cognitiva e no estado metabólico na doença de Alzheimer: um ensaio randomizado, duplo-cego e controlado. Fronteiras na Neurociência do Envelhecimento. 2016, 8(1): 234-240.
3. ANY, et al. Bidirectional Two-Sample, Two-Step Mendelian Randomisation Study Reveals Mediating Role of Gut Microbiota Between Vitamin B Supplementation and Alzheimer's Disease. Nutrients. 2024, 18;16(22): e3929.
4. ANDRADE-GUERRERO J, et al. Alzheimer’s Disease: An Updated Overview of Its Genetics. International Journal of Molecular Sciences. 2023; 24(4): 3754-3777.
5. ASAOKA D, et al. Effect of Probiotic Bifidobacterium breve in Improving Cognitive Function and Preventing Brain Atrophy in Older Patients with Suspected Mild Cognitive Impairment: Results of a 24-Week Randomized, Double-Blind, Placebo-Controlled Trial. Journal of Alzheimers Disease. 2022;88(1):75-95.
6. BARDIN L. Análise de conteúdo. 70 ed. Lisboa. Edições 70, 1977. 230 p. ISBN: 972-44-0898-1
7. BRASIL. Ministério da Saúde. Portaria Conjunta nº 13 de 28 de novembro de 2017. Aprova o Protocolo Clínico e Diretrizes Terapêuticas da Doença de Alzheimer. Diário Oficial da República Federativa do Brasil
8. CHEN Y, et al. Gut microbiome alterations precede cerebral amyloidosis and microglial pathology in a mouse model of Alzheimer's disease. Biomed Research International. 2020;13: e8456596.
9. DE SOUSA MNA, BEZERRA ALD, DO EGYPTO IAS. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. Observatorio de La Economía Latinoamericana. 2023, 21(10): 18448-18483.
10. FANG X, et al. Evaluation of the Anti-Aging Effects of a Probiotic Combination Isolated From Centenarians in a SAMP8 Mouse Model. Frontiers in Immunology. 2021, 12(79): 2746-2758.
11. FEI Y, et al. Probiotic intervention benefits multiple neural behaviors in older adults with mild cognitive impairment. Geriatric Nursing. 2023, 51(1):167-175.
12. GARBACZ K. Anticancer activity of lactic acid bacteria. Seminars in Cancer Biology. 2022, 86(3): 356–366.
13. GUO X, et al. Integração de estudos de associação genômica ampla (GWAS) e dados do microbioma destaca o impacto de bactérias redutoras de sulfato na doença de Alzheimer. Age and Ageing. 2023, 52,(7):73-83
14. HAMAMAH S. et al. Role of microbiota-gut-brain axis in regulating dopaminergic signaling. Biomedicines. 2022, 10(1): 436-451.
15. HIGGINS J. Cochrane handbook for systematic reviews of interventions version 6.5. 2 ed. chichester. cochrane, 2019. 694 p. isbn:9781119536628.
16. HILL NT, et al. Treinamento cognitivo computadorizado em adultos mais velhos com comprometimento cognitivo leve ou demência: uma revisão sistemática e meta-análise. American Journal Psychiatry. 2017, 174;(1) 329–340.
17. HOTEL A. Propriedades nutricionais e de saúde dos probióticos em alimentos, incluindo leite em pó com bactérias lácticas vivas. Anais da consulta conjunta de especialistas da FAO/OMS; Córdoba, Argentina. 2001
18. HOU M, et al. APOE-ε4 Carrier Status and Gut Microbiota Dysbiosis in Patients With Alzheimer Disease. Frontiers Neuroscience. 2021;15: e619051.
19. HUNG CC, et al. Gut microbiota in patients with Alzheimer's disease spectrum: a systematic review and meta-analysis. Aging. 2022; 14: 477–496.
20. ISLAM MT. Oxidative stress and mitochondrial dysfunction-linked neurodegenerative disorders. Neurological Research. 2017, 39(1): 73–82.
21. KAZEMI A, et al. Effect of probiotic and prebiotic vs placebo on psychological outcomes in patients with major depressive disorder: a randomized clinical trial. Clinical Nutrition. 2019, 38(1): 522–528.
22. LEBLHUBER F, et al. Probiotic Supplementation in Patients with Alzheimer’s Dementia - An Explorative Intervention Study. Current Alzheimer Research. 2018, 15(12): 1106-1113
23. LEE EH, et al. Effects of the multidomain intervention with nutritional supplements on cognition and gut microbiome in early symptomatic Alzheimer's disease: a randomized controlled trial. Frontiers Aging Neuroscience. 2023, 2;(15): e1266955.
24. LIU P, et al. Altered microbiomes distinguish Alzheimer's disease from amnestic mild cognitive impairment and health in a Chinese cohort. Brain Behavior Immunology. 2019;80:633-643.
25. LONG JM, HOLTZMAN DM. Alzheimer Disease: An Update on Pathobiology and Treatment Strategies. Cell. 2019; 179(2):312–339.
26. MATHEWSON ND, et al. Gut microbiome-derived metabolites modulate intestinal epithelial cell damage and mitigate graft-versus-host disease. Nature Immunology. 2016,17(5):505-513.
27. NAGPAL R, et al. Modified Mediterranean-ketogenic diet modulates gut microbiome and short-chain fatty acids in association with Alzheimer's disease markers in subjects with mild cognitive impairment. EBioMedicine. 2019, 47(1):529-542.
28. NGANDU T, et al. Uma intervenção multidomínio de 2 anos de dieta, exercício, treinamento cognitivo e monitoramento de risco vascular versus controle para prevenir o declínio cognitivo em idosos em risco (FINGER): um ensaio clínico randomizado. Lancet. 2015, 385(1): 2255–2263.
29. PARK Q, et al. Bidirectional regulatory potentials of short-chain fatty acids and their G-protein-coupled receptors in autoimmune neuroinflammation. Scientific Reports. 2019, 9(9):78-85
30. PATEL V, et al. Déficit global do metabolismo energético no cérebro com doença de Alzheimer. Revista de prevenção da doença de Alzheimer. 2024, 11(1): 171-178
31. RAYANNE P, et al. Atenção Farmacêutica Na Doença de Alzheimer. Research, Society and Development. 2021, 10, (13): 1-9.
32. REN ZL, et al. Causal relationships between gut microbiota and dementia: A two-sample, bidirectional, Mendelian randomization study. World Journal Clinical Cases. 2022;12(16):2780-2788.
33. SINGH R. et al. Influence of diet on the gut microbiome andimplications for human health. Journal of Translational Medicine. 2017, 15(73): 15–29.
34. SOUZA TT, et al. Promoção em saúde mental de adolescentes em países da América Latina: uma revisão integrativa da literatura. Ciência e Saúde Coletiva. 2021, 26(7): 2575-2586.
35. STRASSER B et al. Probiotic supplements beneficially affect tryptophan-kynurenine metabolism and reduce the incidence of upper respiratory tract infections in trained athletes: a randomized, double blinded, placebo-controlled trial. Nutrients. 2016, 8(11): e7522016
36. TCHEKALAROVA J, TZONEVA R. Oxidative Stress and Aging as Risk Factors for Alzheimer’s Disease and Parkinson’s Disease: The Role of the Antioxidant Melatonin. International Journal of Molecular Sciences. 2023, 24(3): 3022-3046.
37. TSAI YC, et al. Gerobiotics: probiotics targeting fundamental aging processes. Bioscience of Microbiota, Food and Health. 2021, 40(1): 1–11.
38. XI C, et al. Can early gut microbiota screening reduce the incidence of cognitive impairment? A Mendelian randomization study. Journal of Alzheimer’s Disease. 2024, 102(1): 195-206.
39. ZHAO Q, et al. Evaluating Causal Effects of Gut Microbiome on Alzheimer's Disease. The Journal of Prevention of Alzheimer's Disease. 2024, 11(6): 1843-1848