Understanding Gut Health For Seniors

The worldwide population of seniors who are aged 60 years old and older is said to be increasing. This may be due to decreased mortality and fertility rates, and will continue to increase. We are looking forward to a future of senior health care.¹ With aging goes a decrease in organ health and functioning, further giving rise to frailty. Frailty is a risk factor for age-related diseases such as injuries, heart diseases and other comorbid diseases that bring about mortality.² One of systems in the body that is greatly affected by aging is the gastrointestinal system and its microbiota which impacts gut health.
This microbiota contains more than 1 trillion microorganisms and assumes a key role in the functioning of body processes that are usually affected by aging. Research studies have shown that age-related abnormalities such as chronic inflammation, diminished mobility, bowel problems, and impairments in memory and cognition are all related to changes in gut microbiota. ³ Thus, we will discuss here why seniors need to pay attention to gut health and what they can do to keep their gut functioning healthy.
 

What Happens To The Gut When We Age?

 
Aging brings about dysbiosis in the gut, which can be due to age-related changes in the body, as well as decreased enzyme functioning in the gastrointestinal system. It can also be due to mucosal barrier changes, diet changes, changes in community dwellings and medications that are usually given to seniors. ⁴
Recent studies have shown that frailty is associated with decreased gut microbiota among seniors in community dwellings such as nursing homes. In this population, changes in gut microbiota may be due to biological aging rather than chronological aging. Also, studies have shown that microbiota composition among seniors is very different from that of young adults. ⁵
One of the age-related changes observed in the gut microbiota of seniors is the increase in Gram-negative bacteria such as Enterobacteriaceae and others. These Gram-negative bacteria often secrete lipopolysaccharides, which act as endotoxins^.6

Lipopolysaccharide is made up of fats and carbohydrates and can cause gut inflammation. There are some studies which have shown that short-chain fatty acids like acetate, butyrate, and propionate in the guts of seniors are decreased as compared to that in younger adults. The decrease in these fatty acids may prompt the release of mucins by the intestinal epithelial cells, which can enable the entry of harmful microorganisms in the intestines. Thus, the creation of short chain fatty acids by gut microbiota is effective against inflammation in the gut, as what is observed in Crohn’s disease and in inflammatory bowel diseases. The decline of these short chain fatty acids caused by aging can also weaken the immune system. ⁷
In another study, it was also noted that genetic changes in immune cells by short chain fatty acids that are created by microbiota can decrease the secretion of inflammatory factors like IL-6. This leads to decreased mucosal permeability in the gut, so that harmful substances such as endotoxins cannot enter the bowels. The ones with more anti-inflammatory activities are acetate and propionate. ⁸
 

How to maintain beneficial gut microbiota for healthy aging?

The factors that affect the composition and function of the gut microbiota are important because these gut microbes have benefits towards health. These microbes prevent diseases in elderly people. One of these factors is diet because it can affect gut microbiota, as the substrates for these microbes are on food. ⁹
For example, vitamin D is important for elderly people. With aging, there is reduced synthesis of cholecalciferol from 7-dehydrocholesterol on the skin after exposure to the sun. If Vitamin D is low, not only does it have a negative impact on calcium balance, it also changes the gut microbiota, further leading to decreased immune resistance.¹⁰
Also, older people consume less fiber because of changes in taste and smell. This can have a negative effect on gut microbiota diversity. Bifidobacteria decreases as we age. Fiber intake is important for elderly people because fiber substrates act as prebiotics that enhance the growth of good bacteria. Fiber is also found to increase healthspan among seniors because it enhances gut microbiota growth and the production of short chain fatty acids. It also improves gut barrier function and increases peptides in the gut that are important in maintaining glucose and fat balance in the body. ¹¹ Also, fiber such as inulin stimulates the growth of Bifidobacteria which can reduce inflammation and prevent constipation.
Like prebiotics, probiotics enhance the growth of good bacteria in the gut microbiota of elderly people. Probiotics are live microorganisms which maintain microbial balance in the gut. ¹²
 

Conclusion

Aging leads to the deterioration of bodily functions. Seniors more than 65 years old are the ones who are more susceptible to these age-related changes. Recently, studies have shown that gut microbiota changes with aging, because aging changes microbial diversity and the functions of gut microbes. This is why seniors are more prone to gastrointestinal diseases as compared to younger adults.
Thus, the maintenance of good gut bacteria can help prevent age-related diseases. An understanding of the mechanisms of the gut microbiota in elderly people have lead to the use of prebiotics, probiotics and fiber as ways of enhancing gut microbial growth.
Eating a healthy diet is one of the ways that can improve the health of seniors. Also, as plant based diets have shown beneficial effects on gut microbiota, they are highly recommended as food to maintain healthy aging.
 
References:

1. Maffei VJ, Kim S, Blanchard E, et al. Biological Aging and the Human Gut Microbiota. J Gerontol A Biol Sci Med Sci. 2017;72(11):1474-1482.
2. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–762. doi:10.1016/S0140-6736(12)62167-9
3. Bindels LB, Delzenne NM. Muscle wasting: the gut microbiota as a new therapeutic target? Int J Biochem Cell Biol. 2013;45:2186–2190. doi:10.1016/j.biocel.2013.06.021
4. Claesson MJ, Jeffery IB, Conde S, et al. Gut microbiota composition correlates with diet and health in the elderly. Nature. 2012;488:178–184. doi:10.1038/nature11319
5. Kumar M, Babaei P, Ji B, Nielsen J. Human gut microbiota and healthy aging: Recent developments and future prospective. Nutr Healthy Aging. 2016;4(1):3-16. Published 2016 Oct 27. doi:10.3233/NHA-150002
6. Schiffrin EJ, Morley JE, Donnet-Hughes A, Guigoz Y. The inflammatory status of the elderly: The intestinal contribution, Mutat Res – Fundam Mol Mech Mutagen [Internet]. Elsevier B.V. 2010;690(1-2):50–56.Available from: 10.1016/j.mrfmmm.2009.07.011″>.
7. Biagi E, Nylund L, Candela M, Ostan R, Bucci L, Pini E, et al. Through ageing, and beyond: Gut microbiota and inflammatory status in seniors and centenarians. PLoS One [Internet]:e10667 2010;5(5). Available from. http://dx.plos.org/10.1371/journal.pone.0010667.
8. Arpaia N, Campbell C, Fan X, Dikiy S, van der Veeken J, deRoos P, et al. Metabolites produced by commensal bacteria promote peripheral regulatory T-cell generation. Nature [Internet]. Nature Publishing Group. 2013;504(7480):451–455. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=884&tool=pmcentrez&rendertype=abstract.
9. David LA, Maurice CF, Carmody RN, Gootenberg DB, Button JE, Wolfe BE, et al. Diet rapidly and reproducibly alters the human gut microbiome Nature [Internet]. Nature Publishing Group; 2014;505(7484):559–563. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3957428&tool=pmcentrez&rendertype=abstract.
10. Oudshoorn C, van der Cammen TJM, McMurdo MET, van Leeuwen JPTM, Colin EM. Ageing and vitamin D deficiency: Effects on calcium homeostasis and considerations for vitamin D supplementation. Br J Nutr [Internet]. 2009;101(11):1597 Available from: http://www.journals.cambridge.org/abstract_S.
11. Keenan MJ, Marco ML, Ingram DK, Martin RJ. Improving healthspan via changes in gut microbiota and fermentation. Age (Dordr). 2015;37(5):98.
12. Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol [Internet]. 2014;11(August 2014):9 Available from. http://www.ncbi.nlm.nih.gov/pubmed/24912386.

 
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