3.8 Age and the menopause

The composition of the gut microbiome changes with age, and this is particularly noticeable after the age of 65 years. The changes that occur can reflect the physical fitness, frailty, and longevity of the individual. In healthy ageing, there is consistently a depletion of some of the core bacterial groups, particularly Bacteroidetes. In contrast, individuals assessed as having a higher degree of frailty have an increase in the levels of Bacteroidetes (Wilmanski, 2021). The decrease in Bacteroidetes seen in healthy ageing also appears to be associated with longevity, and individuals over 100 years of age typically have fewer Bacteroidetes and an increase in rare bacterial groups.

Often these changes in gut microbiome diversity reflect the environmental and personal factors that an individual has been exposed to during their lifetime. As we age, there is age-related decline in the structural integrity of the gut wall, to our internal physiology, and there are many molecular and cellular changes, such as epigenetic changes, all of which can have an impact on the gut microbiome. As a result, an important area of scientific research is exploring the impact of environment, diet, exercise, disease, medication and societal factors and their impact on the ageing gut microbiome (Ghosh, 2022). A better understanding of these factors will hopefully help to promote better health and longevity in ageing (Figure 23).

Figure 23 (a) Ernestine Shepherd and (b) Toshisuke Kanazawa, body builders aged 80 and 81 years, respectively, at the time of these photos, demonstrate that it is possible to maintain good physical health and fitness in the later decades of life

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This figure consists of two photographs labelled (a) and (b). Photograph (a) shows the female body builder, Ernestine Shepherd (aged 80 years), flexing and posing for the camera. Photograph (b) shows the male body builder, Toshisuke Kanazawa (aged 81 years), also flexing and posing for the camera.

Figure 23 (a) Ernestine Shepherd and (b) Toshisuke Kanazawa, body builders aged 80 and 81 years, respectively, at the time of these ...

One particular period of life that affects females is the menopausal period.

There is a sex-related difference in the microbiomes of males and females, however, during the perimenopause and post-menopausal period there is a reduction in diversity and the gut microbiome in females becomes more similar to males (Peters, 2022). At present, there is very little research into the changes in the gut microbiome during the menopausal period, and how hormonal changes contribute to this alteration in bacterial diversity. There are many health-related risks associated with the menopause, and it is unclear whether modification of the gut microbiome after the menopause may help to reduce the risk of developing some of these conditions. Therefore, more research into this area will be essential to try to improve the health and wellbeing of post-menopausal females.