TY - JOUR TI - Effect of administration of a synbiotic (Enterococcus faecium and agave inulin) on cognitive impairment in elderly adults AU - Rojas-Sánchez, Natalia AU - Escandón-Cesarman, Adela AU - Moreno-González, Emilio AU - Delgado-Casillas, Oscar Mario AU - Ibarra García, Andrea P. AU - Ignacio-Mejía, Ivan AU - Albores-Mendez, Exsal Manuel AU - Vargas-Hernandez, Marco Antonio AU - Hernandez-Valdez, Martha Patricia AU - Romaña-Espiritu, Paulina AU - Sanchez-Ávila, Silvia G. AU - Sanchez-Hernandez, María E. AU - Ibarra, Antonio PY - 2026 JO - Exploration of Neuroprotective Therapy VL - 6 SP - 1004156 DO - 10.37349/ent.2026.1004156 UR - https://www.explorationpub.com/Journals/ent/Article/1004156 AB - Aim: To assess the effect of a synbiotic supplement composed of Enterococcus faecium and agave inulin on cognitive function in older adults with mild cognitive impairment (MCI). Methods: In a triple-blind randomized crossover trial, nineteen adults aged 64–85 years with MCI received either the synbiotic or an isocaloric vehicle for eight weeks, followed by a three-week washout and treatment crossover. Cognitive outcomes were assessed at baseline, after the first intervention, and after crossover using the Modified Mini-Mental State Examination (MMSE), Rey-Osterrieth Complex Figure Test (RCFT; copy and memory), and Abbreviated Instrument for Expectations of Self-Efficacy for Daily Activities in Older Adults (AERAC) self-efficacy scale. Paired and unpaired Student’s t-tests were used for statistical comparisons (p < 0.05). Results: The synbiotic group showed significant improvement relative to baseline across all domains: MMSE (p = 0.05), AERAC (p = 0.005), RCFT-copy (p = 0.03), and RCFT-memory (p = 0.03). Post-treatment comparisons between groups also favored the synbiotic, with significant differences in MMSE (p = 0.001), AERAC (p = 0.001), RCFT-copy (p = 0.0095), and RCFT-memory (p = 0.001). After crossover, cognitive gains were sustained and reproduced. MMSE scores reached 17.89 ± 1.45 in the synbiotic-first group versus 18.20 ± 0.63 in the control-first group (p < 0.001). RCFT-copy remained high (29.83 ± 4.18 vs. 29.52 ± 5.60, p = 0.0157), while RCFT-memory scores differed (17.56 ± 6.73 vs. 17.20 ± 3.29, p = 0.0005). AERAC scores continued to improve during crossover (82.60 ± 10.49 vs. 85.46 ± 8.28, p < 0.001). No adverse effects occurred. Conclusions: Synbiotic supplementation significantly improved global cognition, visuoconstructive ability, memory, and functional self-efficacy in older adults with MCI. Benefits persisted beyond the initial intervention and were replicated when the control group received the synbiotic, supporting its potential as a safe and effective strategy to mitigate age-related cognitive decline. ER -