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Probiotics for healthy ageing: Innovation barriers and opportunities for bowel habit improvement in nursing homes

corresponding

OLAF F.A. LARSEN1*, MAURITS VAN DEN NIEUWBOER2, MATTHIJS C. S. KOKS1, JOOST FLACH1, ERIC CLAASSEN1
*Corresponding author
1. Vrije Universiteit Amsterdam, Athena Institute, Amsterdam, The Netherlands
2. New-Med Solutions, Amsterdam, The Netherlands

Abstract

As aging is associated with changes in the diversity and composition of the microbiota, resulting in increased susceptibility to constipation and diarrhoea, probiotics seem to be a promising intervention to modulate and (partially) restore the gut microbiota and its associated disorders. Here, we review the current state of probiotic innovation for elderly nursing home residents with respect to bowel habit improvement. By systematically exploring all aspects of the innovation cycle, including unmet patient needs, efficacy, safety, and health economics, we revealed the main barriers and corresponding opportunities for probiotic valorisation within this domain. Although our results indicate that there is a clear unmet patient need and that probiotic intervention may be both efficacious and safe in improving the bowel habits of elderly residents in nursing homes, only few clinical studies have addressed this problem. High quality clinical studies are required to further drive the probiotic innovation cycle within this domain


INTRODUCTION

The world population is rapidly ageing. Whereas in 1950 about 8% of the total world population was 60 years or older, it is projected that in 2050 this number has increased to more than 20%. For the developed countries, this number even goes up to a staggering ~30% (1). Aging comes at a price, as it is considered to be a risk factor for disease (2,3). The associated costs pose a burden on the economy, as health care expenditures rise with age (4,5). It has currently been demonstrated that ageing is associated with a decline in the composition and quality of the gut microbiota (6). Nursing home residents are an extra vulnerable group, that is negatively affected by the dietary patterns in this type of institutions. Recent studies show that nursing home residents are frailer and exhibit higher comorbidity compared to community dwelling elderly (7). As elderly nursing home residents experience a higher comorbidity, they also experience a more pronounced reduction in quality of life (8), and pose an extra burden on healthcare expenditures when compared to elderly without comorbidity (9). Hence, there seems to be an unmet health need within nursing home ca ...




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