Animal and human studies suggest that inducing changes in the gut microbiota may alter both muscle physiology and cognitive behaviour. Older people’s skeletal muscle displays anabolic resistance to dietary protein, contributing to muscle loss and physical frailty. Gut microbiota may play a role in anabolic resistance. As the population ages, physical and cognitive frailty are increasing in prevalence. In this placebo controlled double blinded randomised controlled trial of 36 twin pairs (72 individuals), aged 60 and over, each twin pair was block randomised to receive either branched chain amino acid (BCAA) supplementation plus placebo or BCAA supplementation plus a prebiotic gut microbiome modulator daily for 12 weeks. Regular resistance exercise was prescribed to all participants. Outcomes were physical function and cognition. The trial was carried out remotely using video visits, online questionnaires, food diaries and cognitive testing, and posting of equipment and biological samples. Here we show that the prebiotic supplement was well tolerated and did result in a changed gut microbiome [e.g., increased Bifidobacterium]. There was no significant difference between prebiotic and placebo for the primary outcome of chair rise time (β=0.579; 95% CI -1.080-2.239 p=0.494). The Prebiotic improved cognition (first factor score versus placebo (β=0.482; 95% CI 0.141-0.823; p=0.014)). Our results demonstrate that cheap and readily available gut microbiome interventions may improve cognition in our ageing population. We also illustrate the feasibility of remotely delivered trials for older people, which holds promise for future studies in this area, which could reduce the under-representation of older people in clinical trials. This study is registered with ClinicalTrials.gov (NCT04309292).Animal and human studies suggest that inducing changes in the gut microbiota may alter both muscle physiology and cognitive behaviour. Older people’s skeletal muscle displays anabolic resistance to dietary protein, contributing to muscle loss and physical frailty. Gut microbiota may play a role in anabolic resistance. As the population ages, physical and cognitive frailty are increasing in prevalence. In this placebo controlled double blinded randomised controlled trial of 36 twin pairs (72 individuals), aged 60 and over, each twin pair was block randomised to receive either branched chain amino acid (BCAA) supplementation plus placebo or BCAA supplementation plus a prebiotic gut microbiome modulator daily for 12 weeks. Regular resistance exercise was prescribed to all participants. Outcomes were physical function and cognition. The trial was carried out remotely using video visits, online questionnaires, food diaries and cognitive testing, and posting of equipment and biological samples. Here we show that the prebiotic supplement was well tolerated and did result in a changed gut microbiome [e.g., increased Bifidobacterium]. There was no significant difference between prebiotic and placebo for the primary outcome of chair rise time (β=0.579; 95% CI -1.080-2.239 p=0.494). The Prebiotic improved cognition (first factor score versus placebo (β=0.482; 95% CI 0.141-0.823; p=0.014)). Our results demonstrate that cheap and readily available gut microbiome interventions may improve cognition in our ageing population. We also illustrate the feasibility of remotely delivered trials for older people, which holds promise for future studies in this area, which could reduce the under-representation of older people in clinical trials. This study is registered with ClinicalTrials.gov (NCT04309292).

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