Context Dementia is the fifth leading cause of death in the world. Animal studies indicate that in addition to the aging process, intestinal microbiota may play an important role in the neurodegeneration process through the modulation of the gut-brain axis. Objective A systematic review and meta-analysis was conducted to determine the effectiveness of probiotic and synbiotic supplementation on the cognitive function of individuals with dementia. Data Sources MEDLINE, BVS, SciELO, CENTRAL, Embase, and grey literature were searched from their inception to January 2019. Study Selection We included data from randomized clinical trials (RCTs) that addressed dementias and assessed the following outcomes: cognitive function; inflammatory, oxidative stress, and metabolic markers; nutritional status; and intestinal microbiota composition. Data Extraction Data searches, article selection, data extraction, and risk-of-bias assessments were performed according to the Cochrane guidelines. Data were pooled by inverse-variance random-effects meta-analyses. GRADE (Grading of Recommendations Assessment, Development, and Evaluations) was used to assess the quality of evidence. Results Data from 3 RCTs involving 161 individuals with Alzheimer’s disease receiving Lactobacillus and Bifidobacterium strains showed no beneficial effect of probiotic supplementation on cognitive function (standardized mean difference, 0.56; 95%CI: −0.06 to 1.18), with very low certainty of evidence. However, probiotic supplementation improved plasma triglycerides, very-low-density lipoprotein cholesterol, insulin resistance, and plasma malondialdehyde. No RCTs included synbiotic supplementation or assessed microbiota composition. Conclusion Current evidence regarding the use of probiotics and synbiotics for individuals with dementia is insufficient to support their clinical application. Systematic Review Registration PROSPERO registration no: CRD42018116148.

Background Studies have shown an increase in the number of patients who use enteral nutrition at home and the benefits of this type of nutrition care. However, little is known about the risk of bacterial contamination of enteral formulations prepared at home. Therefore, the aim of the study was to assess the microbiological quality of home‐prepared enteral formulations. Methods This study is a systematic review, registered in PROSPERO. The search for articles was carried out in databases and gray literature. Eligible studies that microbiologically analyzed homemade enteral preparations (HEPs), blended enteral preparations (BEPs), and commercial enteral formulas (CEFs) that were prepared at home were selected. The types and quantities of microorganisms, sources of contamination in the handling area, and the consequences of contamination (signs and symptoms) were the subjects extracted from the studies. Results Five studies evaluated 217 enteral formulations. It was found that 72.81% of the enteral formulations exceeded the acceptable bacterial count in the case of at least one of the analyzed microorganisms. This result corresponded to 93.58% (n = 73) of the HEPs, 81.96% (n = 50) of the BEPs, and 44.87% (n = 35) of the CEFs. The presence of 10 different microorganisms was identified in the enteral formulations, and total coliforms and mesophilic aerobics were the microorganisms found in the greatest quantity in the samples. Conclusion The three types of home‐prepared enteral formulations showed unsatisfactory microbiological quality, indicating poor hygiene conditions during food handling.

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