The Relationship Between Gut Microbiota, Muscle Mass and Physical Function in Older Individuals: A Systematic Review

Background: Recent evidence suggests that sarcopenia and subsequent changes in muscle mass and functional outcomes are linked to disruption to the gastrointestinal microbiota composition and/or function via the microbiota-gut-muscle axis. Despite growing interest, few studies have systemically analysed (1) the relationship between the gut microbiota, muscle mass and physical performance and (2) the effects of gut-modulating dietary interventions on these outcomes within older individuals with or without sarcopenia. Methods: Four electronic databases (PubMed, MEDLINE, Embase and Scopus) were searched for articles published from the year 2004 until July 2023. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. Revised Cochrane Risk of Bias (RoB 2.0) and Joanna Briggs Institute (JBI) critical appraisal checklist were utilised to evaluate the risk of bias within intervention and observational studies, respectively. Results: A total of 20 studies (14 observational and 6 interventional) involving 4071 older participants (mean age 69.9 years, 51.6% female) were included. There was significant heterogeneity regarding interventions and outcome measures used in these studies. Correlations between microbiota diversity and composition and sarcopenia-related functional outcomes were observed. Interventional studies targeting the gut microbiota resulted in improved muscle strength, body composition or physical function in some, but not all, studies. Conclusions: Despite limitations in the studies reviewed, the findings provide further evidence that the development of sarcopenia is likely influenced by an altered gut microbial environment and that interventions targeting the microbiome could hold therapeutic potential for the treatment or management of sarcopenia.