Alterations in intestinal microbiota composition are associated with several chronic conditions, including obesity and inflammatory diseases. The microbiota of older people displays greater inter-individual variation than that of younger adults. Here we show that the faecal microbiota composition from 178 elderly subjects formed groups, correlating with residence location in the community, day-hospital, rehabilitation or in long-term residential care. However, clustering of subjects by diet separated them by the same residence location and microbiota groupings. The separation of microbiota composition significantly correlated with measures of frailty, co-morbidity, nutritional status, markers of inflammation and with metabolites in faecal water. The individual microbiota of people in long-stay care was significantly less diverse than that of community dwellers. Loss of community-associated microbiota correlated with increased frailty. Collectively, the data support a relationship between diet, microbiota and health status, and indicate a role for diet-driven microbiota alterations in varying rates of health decline upon ageing
Health–microbiota associations were statistically significant, even when regression models were adjusted for location. Although other factors undoubtedly contribute to health decline, and are difficult to completely adjust for in retrospective studies, the most plausible interpretation of our data is that diet shapes the microbiota, which then affects health in older people. Diet-determined differences in microbiota composition may have subtle impacts in young adults in developed countries. These would be difficult to correlate with health parameters, but become far more evident in the elderly who are immuno-physiologically compromised. This is supported by the stronger microbiota–health associations evident in the long-stay cohort, and there is now a reasonable case for microbiota-related acceleration of ageing-related health deterioration. An ageing population is now a general feature of western countries and an emerging phenomenon even among developing countries. The association of the intestinal microbiota of older people with inflammation and the clear association between diet and microbiota outlined in this and previous studies argue in favour of an approach of modulating the microbiota with dietary interventions designed to promote healthier ageing. Dietary supplements with defined food ingredients that promote particular components of the microbiota may prove useful for maintaining health in older people. On a community basis, microbiota profiling, potentially coupled with metabolomics, offers the potential for biomarker-based identification of individuals at risk for, or undergoing, less-healthy ageing.
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