{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:45Z","timestamp":1789535085187,"version":"build-2803163510"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Preserving cognitive and physical function is central to healthy aging, and the gut microbiota may influence both brain and muscle physiology. We evaluated whether live microorganism-based interventions affect cognitive and muscle-related outcomes in aging adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We systematically reviewed randomized placebo-controlled trials of probiotics, synbiotics, or fecal microbiota transplantation in populations with a mean age of at least 60 years. MEDLINE, Embase, Web of Science, and the Cochrane Library were searched. Random-effects meta-analyses used Hedges\u2019 g when at least three studies or independent comparisons reported sufficiently comparable outcomes. The protocol was prospectively registered in PROSPERO (CRD420251065993;\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251065993<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-four trials involving 1,809 participants were included qualitatively: 20 evaluated cognitive outcomes and four evaluated muscle-related outcomes. Eleven unique studies contributed to at least one meta-analysis. For Mini-Mental State Examination scores, the overall pooled estimate was positive (\n                      <jats:italic>g<\/jats:italic>\n                      = 1.02; 95% CI: 0.36\u20131.68;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 90.84%). In exploratory\n                      <jats:italic>post hoc<\/jats:italic>\n                      subgroup analyses, the estimate was positive in Alzheimer\u2019s disease (\n                      <jats:italic>g<\/jats:italic>\n                      = 1.46; 95% CI: 1.14\u20131.79) but not statistically significant in broader cognitive impairment (\n                      <jats:italic>g<\/jats:italic>\n                      = 0.49; 95% CI: \u22120.78 to 1.77); the subgroup difference was not significant (p = 0.15). Excluding both Akhgarjand et al. intervention arms yielded a positive estimate in Alzheimer\u2019s disease (\n                      <jats:italic>g<\/jats:italic>\n                      = 1.63; 95% CI: 1.21\u20132.06), although only two studies remained. The pooled Repeatable Battery for the Assessment of Neuropsychological Status result was not statistically significant (\n                      <jats:italic>g<\/jats:italic>\n                      = 0.46; 95% CI: \u22120.50 to 1.41). Handgrip strength showed a modest positive estimate (\n                      <jats:italic>g<\/jats:italic>\n                      = 0.46; 95% CI: 0.06\u20130.85), but exclusion of Qaisar et al. attenuated it to non-significance (\n                      <jats:italic>g<\/jats:italic>\n                      = 0.23; 95% CI: \u22120.27 to 0.73).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Live microorganism-based interventions showed preliminary short-term functional signals, but the small evidence base, high cognitive heterogeneity, short follow-up, and sensitivity to individual studies preclude firm efficacy conclusions. Subgroup and two-study sensitivity findings are exploratory. No eligible fecal microbiota transplantation trial was identified, so the evidence derives exclusively from probiotic and synbiotic studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251065993<\/jats:ext-link>\n                      , unique identifier: CRD420251065993.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1869929","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:33:39Z","timestamp":1789533219000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Can live microbial interventions support healthy aging? A systematic review and meta-analysis of cognitive and muscle outcomes in aging adults"],"prefix":"10.3389","volume":"13","author":[{"given":"Francisco","family":"Silva-Olivares","sequence":"first","affiliation":[{"name":"Instituto de Nutrici\u00f3n y Tecnolog\u00eda de los Alimentos (INTA), Universidad de Chile","place":["Santiago, Chile"]},{"name":"Facultad de Salud y Ciencias Sociales, Universidad de las Am\u00e9ricas, Sede Providencia","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Vidal","sequence":"additional","affiliation":[{"name":"Centro de Neurobiolog\u00eda y Fisiopatolog\u00eda Integrativa (CENFI), Instituto de Fisiolog\u00eda, Universidad de Valpara\u00edso","place":["Valpara\u00edso, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Acevedo-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Centro Interdisciplinario de Neurociencia de Valpara\u00edso (CINV), Universidad de Valpara\u00edso","place":["Valpara\u00edso, Chile"]},{"name":"Centro de Estudios Traslacionales en Estr\u00e9s y Salud Mental (C-estr\u00e9s), Universidad de Valpara\u00edso","place":["Valpara\u00edso, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Rabbia","sequence":"additional","affiliation":[{"name":"Farncombe Family Digestive Health Research Institute, McMaster University","place":["Hamilton, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Petermann-Rocha","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica, Facultad de Medicina, Universidad Diego Portales","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samanta","family":"Thomas-Vald\u00e9s","sequence":"additional","affiliation":[{"name":"Centro de Micro-Bioinnovaci\u00f3n, Escuela de Nutrici\u00f3n y Diet\u00e9tica, Facultad de Farmacia, Universidad de Valpara\u00edso","place":["Valpara\u00edso, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo","family":"Jorquera","sequence":"additional","affiliation":[{"name":"Instituto de Nutrici\u00f3n y Tecnolog\u00eda de los Alimentos (INTA), Universidad de Chile","place":["Santiago, Chile"]},{"name":"Instituto de Fisiolog\u00eda, Universidad de Valpara\u00edso","place":["Valpara\u00edso, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref1","volume-title":"UN Decade of Healthy Ageing: Plan of Action","year":"2020"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1007\/s10522-026-10389-1","article-title":"Age-driven dysbiosis: gut microbiota in the pathogenesis and treatment of aging 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