Utilizing the Microbiome in Geriatric Clinics: Current Insights and Future Perspectives

As the global population ages, geriatric care is shifting from simply extending life to preserving healthspan and functional ability.The gut microbiome regulates host metabolism, immune function, intestinal barrier function, and neural signaling, and is implicated in aging and diverse age-related conditions.In older adults, dysbiosis is frequently associated with limited dietary variety, decreased physical activity, polypharmacy, recurrent hospitalization, and antibiotic exposure.These alterations may contribute to conditions such as sarcopenia, frailty, cognitive decline, metabolic dysfunction, and gastrointestinal issues through increased age-related chronic low-grade inflammation (inflamm-aging), compromised intestinal barrier function, and reduced short-chain fatty acid synthesis.This review outlines the key mechanisms linking aging to gut microbiome alterations and examines their relevance to common geriatric clinical problems.We propose practical management strategies, including dietary interventions, promotion of physical activity, the judicious use of probiotics and prebiotics, and medication review, particularly of antibiotics and proton pump inhibitors.Current evidence limitations and future directions in precision geriatric medicine are also addressed.