Are self-reported gastrointestinal symptoms among older adults associated with increased intestinal permeability and psychological distress?

Abstract

BackgroundDespite the substantial number of older adults suffering from gastrointestinal (GI) symptoms little is known regarding the character of these complaints and whether they are associated with an altered intestinal barrier function and psychological distress. Our aim was to explore the relationship between self-reported gut health, intestinal permeability and psychological distress among older adults.MethodsThree study populations were included: 1) older adults with GI symptoms (n = 24), 2) a group of older adults representing the general elderly population in Sweden (n = 22) and 3) senior orienteering athletes as a potential model of healthy ageing (n = 27). Questionnaire data on gut-health, psychological distress and level of physical activity were collected. Intestinal permeability was measured by quantifying zonulin in plasma. The level of systemic and local inflammation was monitored by measuring C-reactive protein (CRP), hydrogen peroxide in plasma and calprotectin in stool samples. The relationship between biomarkers and questionnaire data in the different study populations was illustrated using a Principal Component Analysis (PCA).ResultsOlder adults with GI symptoms displayed significantly higher levels of both zonulin and psychological distress than both general older adults and senior orienteering athletes. The PCA analysis revealed a separation between senior orienteering athletes and older adults with GI symptoms and showed an association between GI symptoms, psychological distress and zonulin.ConclusionsOlder adults with GI symptoms express increased plasma levels of zonulin, which might reflect an augmented intestinal permeability. In addition, this group suffer from higher psychological distress compared to general older adults and senior orienteering athletes. This relationship was further confirmed by a PCA plot, which illustrated an association between GI symptoms, psychological distress and intestinal permeability.

Differential effects of dietary fibres on colonic barrier function in elderly individuals with gastrointestinal symptoms

“…However intake of ASA or any other medication was found not to affect the intestinal permeability. This is in accordance with a recent study from our group demonstrating that the use of pharmaceutical agents did not affect plasma levels of zonulin, an indirect marker of small intestinal permeability 24 .…”

“…The observed elevated baseline permeability among elderly with GI symptoms is in line with previous results where we, among others, have identified an increase in small bowel permeability among elderly 30 and those suffering from GI symptoms 24 . A recent study further shows that aged mice display an increased colonic permeability compared to young mice which trigger systemic inflammation, due to age-associated changes of the gut microbiota 31 .…”

“…Thus, MCs represents a potential link between psychological distress and a disturbed intestinal barrier function which might be one of the mechanisms behind the increased GI problems in the elderly population. Recently, we showed that elderly individuals self-reporting moderate GI symptoms also suffered from psychological distress and displayed signs of a perturbed intestinal barrier function 24 .…”

Gut Health, Nutrient intake and Well-being in Community-Dwelling Older Adults

“…Ganda Mall et al, 2018). However, no correlation was found between a low fibre intake and GI symptoms or increased stress-levels, respectively.…”

“…Dietary intake and dietary patterns are known to affect health and well-being (Jacka et al, 2010) and also known to influence gut health either through direct effects (J. P. Ganda Mall et al, 2018) or indirectly by influencing the gut microbiota composition (Claesson et al, 2012;Mitsou et al, 2017). Age-related physiological changes are further known to influence older adults' nutrient intake, such as decreased sense of smell, taste, satiety and hunger (S. B.…”