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Gut Health and Non-cognitive Symptoms of Dementia: A Systematic Review of Gut-Targeted Therapies on Neuropsychiatric Symptoms in Alzheimer's Disease
| Resumo: | Background Alzheimer's disease (AD) is the most common cause of dementia worldwide, with up to 90% of patients experiencing neuropsychiatric symptoms (NPS) including agitation, aggression, apathy, anxiety, depression, and psychosis. These symptoms significantly worsen patients' quality of life and greatly increase caregiver burden, highly contributing to the social and economic toll of the disease. Recent evidence suggests that gut microbiota modulation through probiotics, prebiotics, and gut-targeted therapies may influence neuroinflammation and neurotransmitter activity, potentially aiding in the management of NPS in AD. Objective To systematically review and appraise the evidence on the effects of probiotics, prebiotics, and other gut-targeted therapies on NPS in patients with AD. Methods A systematic review was conducted in compliance with PRISMA guidelines. Systematic searches were conducted in PubMed, Scopus, Web of Science, PsycInfo, Google Scholar, and BASE from database inception. Additional manual searches were conducted to screen the reference lists of previous systematic reviews and included studies. Eligible studies included randomized controlled trials and non-randomized studies investigating gut-targeted interventions in AD patients, with NPS assessed using validated scales such as the Neuropsychiatric Inventory (NPI). Risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2). Results Eight studies including 2005 participants from 5 countries met the inclusion criteria. Probiotic supplementation showed significant benefits in reducing anxiety, while omega-3 fatty acids demonstrated selective improvements in agitation and depression. Sodium oligomannate exhibited no significant effects on NPS. Conclusions Gut microbiota modulation presents a promising avenue for NPS management in AD, though evidence remains limited and inconsistent. Further large-scale, well-designed and adequately powered trials are needed to clarify therapeutic potential and optimize intervention strategies. |
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| Assunto: | Medicina clínica Clinical medicine |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | Restrito |
| Instituição associada: | Repositório Aberto da Universidade do Porto |
| Idioma: | inglês |
| Origem: | Repositório Aberto da Universidade do Porto |
| Resumo: | Background Alzheimer's disease (AD) is the most common cause of dementia worldwide, with up to 90% of patients experiencing neuropsychiatric symptoms (NPS) including agitation, aggression, apathy, anxiety, depression, and psychosis. These symptoms significantly worsen patients' quality of life and greatly increase caregiver burden, highly contributing to the social and economic toll of the disease. Recent evidence suggests that gut microbiota modulation through probiotics, prebiotics, and gut-targeted therapies may influence neuroinflammation and neurotransmitter activity, potentially aiding in the management of NPS in AD. Objective To systematically review and appraise the evidence on the effects of probiotics, prebiotics, and other gut-targeted therapies on NPS in patients with AD. Methods A systematic review was conducted in compliance with PRISMA guidelines. Systematic searches were conducted in PubMed, Scopus, Web of Science, PsycInfo, Google Scholar, and BASE from database inception. Additional manual searches were conducted to screen the reference lists of previous systematic reviews and included studies. Eligible studies included randomized controlled trials and non-randomized studies investigating gut-targeted interventions in AD patients, with NPS assessed using validated scales such as the Neuropsychiatric Inventory (NPI). Risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2). Results Eight studies including 2005 participants from 5 countries met the inclusion criteria. Probiotic supplementation showed significant benefits in reducing anxiety, while omega-3 fatty acids demonstrated selective improvements in agitation and depression. Sodium oligomannate exhibited no significant effects on NPS. Conclusions Gut microbiota modulation presents a promising avenue for NPS management in AD, though evidence remains limited and inconsistent. Further large-scale, well-designed and adequately powered trials are needed to clarify therapeutic potential and optimize intervention strategies. |
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