Celiac disease in the elderly

Abstract

Celiac disease is a common condition that is thought to affect 1 in 200 people throughout Europe and America, with prevalence rates reaching 1:100 in Ireland. Improvements in the sensitivity and specificity of serological testing for celiac disease over the past 15 years have resulted in a larger number of diagnoses being made. Up to 34% of patients with newly diagnosed celiac disease are older than 60 years of age. The symptomatic presentation of celiac disease in elderly patients can be subtle, leading to a considerable delay in diagnosis and potential accumulation of associated secondary complications. Given that celiac disease is associated with significant morbidity and reduced life expectancy, physicians need to be aware of this condition and its occurrence in the current increasingly elderly population. Compliance with a strict gluten-free diet is as easily achieved in elderly patients as in younger patients, and has been reported to reduce the risks of cancer and lymphoma associated with celiac disease. This Review highlights age-related differences in the clinical presentation and investigation of patients with suspected celiac disease.

Celiac Disease: Similar Presentations in the Elderly and Young Adults

“…Data suggest that the incidence of celiac disease is increasing in the adult population, particularly among the elderly. Recent studies report that the incidence ranges from 19% to 34% in this age group [9,10]. Data from Murray et al [8] suggest that the incidence rates are continuing to rise in the elderly.…”

Fast food fever: reviewing the impacts of the Western diet on immunity

“…In patients with celiac, a particular MHC receptor, either HLA-DQ2 or HLA-DQ8, allows the processed gluten to act as a sort of super-antigen, binding the APC to the CD4+ T-cell without going through normal processing; this inappropriately activates the T-cell and results in inflammation and symptoms [84-87]. However, HLA-DQ2 and HLA-DQ8 are found in approximately 40% of the US population and yet only roughly 1% of the US carries the diagnosis of celiac [88,89]. Therefore, some additional undiscovered mechanisms as well as genetic and/or environmental risk factors must be present.…”

Mujer anciana con diarrea crónica

“…La forma de presentación en ancianos no difiere de los adultos jóvenes aunque parece que están asintomáticos en un mayor porcentaje 3 .…”

“…La EC también se ha asociado con demencia en menores de sesenta años y, al parecer, en pacientes con deterioro cognitivo leve, éste puede ser revertido mediante una dieta estricta sin gluten 3 . Esta retirada del gluten en los pacientes diagnosticados en la edad adulta provoca una mejoría significativa en síntomas gastrointestinales que podrían incluso haber pasado desapercibidos para el paciente 15 .…”