Probiotics for Mild Cognitive Impairment and Alzheimer's Disease: A Systematic Review and Meta-Analysis

Accumulating evidence from animal studies supports the potential role of probiotics and prebiotics in alleviating neurodegenerative diseases. However, whether dietary supplementation with probiotics improves cognitive function in patients with Alzheimer's disease (AD) or mild cognitive impairment (MCI) is unclear. We searched literature databases for relevant randomized control trials and compared the outcomes between control/placebo and intervention groups. The results of the included studies were meta-analyzed using a random-effects model, with standardized mean differences (SMDs) and 95% confidence intervals (CIs) calculated as summary statistics. We also performed a risk-of-bias assessment, sensitivity analysis and subgroup analysis. Among the 294 articles identified, eight articles involving 174 patients with AD and 446 with MCI were included in the qualitative synthesis and seven studies were meta-analyzed. Our analysis detected high between-group heterogeneity (SMD = 0.43, 95% CI -0.02-0.88, p < 0.0001, I² = 86.4%) in cognitive function across the included studies. Subgroup analyses identified a significant effect of probiotics on cognitive function only in the studies involving people with MCI (I² = 44%, p = 0.15 for heterogeneity, p = 0.0002 for overall effect). Our findings suggest that dietary supplementation with probiotics improves cognitive function, especially in people with MCI.