Increasing prevalence and high incidence of celiac disease in elderly people: A population-based study

Abstract

BackgroundCeliac disease may emerge at any age, but little is known of its appearance in elderly people. We evaluated the prevalence of the condition in individuals over 55 years of age, and determined the incidence of biopsy-proven celiac disease (CDb) and celiac disease including seropositive subjects for anti-tissue transglutaminase antibodies (CDb+s).MethodsThe study based on prevalence figures in 2815 randomly selected subjects who had undergone a clinical examination and serologic screening for celiac disease in 2002. A second screening in the same population was carried out in 2005, comprising now 2216 individuals. Positive tissue transglutaminase antibodies were confirmed with small bowel biopsy.ResultsWithin three years the prevalence of CDb increased from 2.13 to 2.34%, and that of CDb+s from 2.45 to 2.70%. Five new cases were found among patients previously seronegative; two had minor abdominal symptoms and three were asymptomatic. The incidence of celiac disease in 2002–2005 was 0.23%, giving an annual incidence of 0.08% in this population.ConclusionThe prevalence of celiac disease was high in elderly people, but the symptoms were subtle. Repeated screening detected five biopsy-proven cases in three years, indicating that the disorder may develop even in the elderly. Increased alertness to the disorder is therefore warranted.

Age-related differences in celiac disease: Specific characteristics of adult presentation

“…Similar studies in Brazil and India also found twice the CD frequency in children [7,8] . However, these data are in contrast with the observed prevalence in adult populations from European countries such as the United Kingdom (1.2%) [9] and, more surprisingly, Finland, where a 2.4% prevalence of CD was demonstrated by biopsy in a population of adults over fifty years of age [10] . The pediatric population was not analyzed in these studies, but prevalence of over 1%, even in older populations, is similar to that observed in pediatric studies.…”

Morbidity and Mortality Among Older Individuals With Undiagnosed Celiac Disease

“…Finally, a recent study suggests that loss of tolerance in CD may occur late in life. 36 Thus, because of the cross-sectional design of the serologic testing in our study, we cannot exclude that late onset CD may explain the lack of morbidity and mortality in some of our patients with undiagnosed CD.…”

Mujer anciana con diarrea crónica

“…La secuencia de eventos (aparición de anticuerpos, desarrollo de la enteropatía intestinal, comienzo de los síntomas y, finalmente, desarrollo de las complicaciones) no necesariamente tiene que ocurrir en cada paciente 4 . Tampoco está claro que una determinación de anticuerpos negativa sea suficiente para excluir la EC, ya que la seroconversión puede ocurrir años después del inicio de los 5 . Por tanto, la susceptibilidad genética y la ingesta de gluten en la dieta son necesarios pero no suficientes para desarrollar la enfermedad celiaca 4 .…”