The Nursing Home Older Adult Gut Microbiome Composition Shows Time-dependent Dysbiosis and Is Influenced by Medication Exposures, Age, Environment, and Frailty
The Nursing Home Older Adult Gut Microbiome Composition Shows Time-dependent Dysbiosis and Is Influenced by Medication Exposures, Age, Environment, and Frailty
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DOI：
10.1093/gerona/glab167
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发表时间：
2021-06-14
影响因子：
5.1
通讯作者：
McCormick, Beth A.
中科院分区：
文献类型：
--
作者：
Haran, John P.;Zeamer, Abigail;McCormick, Beth A.
养老院（NH）的老年人虚弱，药物和抗菌素暴露增加，所有这些因素都已知会影响肠道微生物群的组成。我们的目标是确定哪些因素与NH居民肠道微生物群有最大的关联，探索在这种环境中随着时间的推移肠道微生物群的生态失调和组成变化的模式。我们收集了NH居民的连续粪便样本。使用迷你营养评估工具和临床虚弱量表对居民进行评估。通过宏基因组测序确定居民粪便样品的细菌组成。我们使用混合效应随机森林模型来识别与微生物群相关的临床协变量。我们招募并随访了来自5个NHs的166名居民，收集了512份粪便样本，并随访了15名居民> 1年。药物，特别是精神药物和抗高血压药物，对微生物群的影响最大。年龄和虚弱也有贡献，并分别与增加和减少的多样性。在NH居住> 1年的居民的微生物群富含炎症和致病物种，而抗炎和共生物种减少。我们观察到在NH生活超过1年的老年人中微生物组的个体内稳定性，随后间隔1年进行样本收集。老年人NH肠道微生物组受药物，年龄和虚弱的严重影响。这种微生物组受到NH驻留时间的影响，在12个月时生态失调变得明显，然而，在这一点之后，随着时间的推移，表现出相对稳定性。
Older adults in nursing homes (NHs) have increased frailty, medication, and antimicrobial exposures, all factors that are known to affect the composition of gut microbiota. Our objective was to define which factors have the greatest association with the NH resident gut microbiota, explore patterns of dysbiosis and compositional changes in gut microbiota over time in this environment. We collected serial stool samples from NH residents. Residents were assessed using the Mini Nutritional Assessment tool and Clinical Frailty Scale. Bacterial composition of resident stool samples was determined by metagenomic sequencing. We used mixed-effect random forest modeling to identify clinical covariates that associate with microbiota. We enrolled and followed 166 residents from 5 NHs collecting 512 stool samples and following 15 residents for > 1 year. Medications, particularly psychoactive and antihypertensive medications, had the greatest effect on the microbiota. Age and frailty also contributed, and were associated with increased and decreased diversity, respectively. The microbiota of residents who had lived in the NH for > 1 year were enriched in inflammatory and pathogenic species and reduced in anti-inflammatory and symbiotic species. We observed intraindividual stability of the microbiome among older adults who had lived in the NH already for >1 year followed with sample collections 1 year apart. Older adult NH gut microbiome is heavily influenced by medications, age, and frailty. This microbiome is influenced by the length of NH residency with dysbiosis becoming evident at 12 months, however, after this point there is demonstrated relative stability over time.