Celiac Disease In Older People

Yes, you can get celiac in middle age, or even later

older people can get celiac disease
Older people can get celiac disease. Lucia Lambriex/Getty Images

Until the mid-1990s, few people thought celiac disease could develop in older people. Instead, doctors assumed celiac disease only occurred in children. Babies had celiac disease (or celiac sprue, as it was called), and they usually outgrew it — or so people thought.

Now, we know better. Celiac disease is a life-long condition. It affects people of all ages and all body shapes. The symptoms can be obvious, or subtle, or even non-existent.

 

Celiac Can Affect Those in Middle Age and Older

It was startling to some researchers years ago to find that middle-aged adults could have celiac disease. So it's perhaps even more surprising to learn how many older people are walking around with undiagnosed celiac disease right now.

As a group of researchers in Finland said when they analyzed the rate of celiac disease among those ages 52 to 74: “We [thought] that they would over time have developed obvious symptoms.” But in fact, only 25% of those with celiac disease in this study had symptoms, and their symptoms were mostly mild.

A few of the subjects did have intestinal lymphoma or gastric cancer, which can occur in people with celiac disease who aren't following the gluten-free diet (which you probably aren't doing if you don't even realize you have celiac). In addition, the Finnish researchers found that the prevalence of celiac disease in their group of elderly people was more than twice as high as in the general population.

Celiac Symptoms Included Dementia

There's some evidence that celiac disease can cause dementia in older people, and that this dementia may be reversible in some cases.

In one study — this one involving just seven people over age 60 — two of the women in the study had symptoms that included “cognitive decline that was attributed to Alzheimer dementia but [improved] after the initiation of gluten-free diet.” A third person had a condition called peripheral neuropathy (numbness, weakness, or burning pain in the arms or legs) that disappeared after the person started to eat gluten-free.

The Israeli doctors’ other older patients had more typical symptoms, such as weight loss, iron deficiency anemia, diarrhea, and severe early osteoporosis.

Sadly, it took a median of eight years for this group of people to be diagnosed with celiac disease, and in that time one person developed intestinal lymphoma, which ultimately proved fatal. Even so, the researchers said, in most of these older people, the gluten-free diet led to “complete resolution of symptoms… and a significant weight gain.”

Doctors at the Mayo Clinic in the U.S. also wrote about older adults with celiac disease and cognitive impairment, including confusion, memory loss, and personality changes. In this report, though, only three of the doctors’ 13 patients improved or stabilized on the gluten-free diet.

Is Going Gluten-Free Worth the Trouble?

Some older people might question whether it's worth it to go gluten-free, since the diet can be difficult to follow. However, one 1994 study that looked at 42 people over age 60 concluded that it's worth it: "Patients often only realize how unwell they were in retrospect after commencing a gluten-free diet ...

[Our patients] had come to accept quite marked ill health as normal."

The people in this study all experienced improvements in the results of certain medical tests that could indicate a risk for bone fractures, among other things. More importantly, though, they generally just felt better.

The Bottom Line

People with undiagnosed celiac disease are at risk for very serious health issues, including cancer. If you or anyone in your immediate family has celiac disease, make sure the older people in your family are aware that they might be at risk for the disease, too, particularly if they're a first- or second-degree relative. You might be able to help them learn how to eat gluten-free, as well.

Finally, if you’re an older person and you think you might have celiac disease — and especially if you have anemia and chronic diarrhea — then by all means talk to your doctor about it. You might be surprised at how much better you can feel.

Sources:

Hankey GL, Holmes GK. Coeliac disease in the elderlyGut. 1994;35:65-67.

Hu WT et al. Cognitive impairment and celiac disease. Archives of Neurology. 2006;63:1440-46.

Lurie Y et al. Celiac disease diagnosed in the elderlyJournal of Clinical Gastroenterology. 2008;42:59-61.

Rashtak M et al. Celiac Disease in the ElderlyGastroenterology Clinics of North America. 2009 Sept 38(3):433-446.

Vilppula A et al. Undetected coeliac disease in the elderly: a biopsy-proven population-based studyDigestive and Liver Diseases. 2008;40:809-13.

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