Are People with Celiac Disease At Risk for Dementia?

People with celiac disease frequently report cognitive symptoms when they are exposed to gluten, and clinicians have documented cognitive deficits in some patients with newly diagnosed celiac disease. A team of researchers recently set out to determine whether patients with celiac disease have an increased risk of dementia.

The research team included Benjamin Lebwohl, José A. Luchsinger, Daniel E. Freedberg, Peter H.R. Green, and Jonas F. Ludvigsson. They are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; the Department of Medical Epidemiology and Biostatistics, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden; the Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; the Department of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA; and the Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.

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For their study, the team used a population-based database of adults aged 50 years and older with histologically proven celiac disease; that is, patients showing duodenal/jejunal villous atrophy. The database included patients from all 28 pathology departments in Sweden.

The team compared the incidence of a subsequent dementia diagnosis to those of age- and gender-matched controls.

In all, the team reviewed data on 8,846 patients with celiac disease, and 43,474 control subjects, with a median age of 63 years; 56% were female. Over an average follow-up time of 8.4 years, 4.3% of celiac disease patients were diagnosed with dementia, compared with 4.4% of control subjects (HR 1.07; 95% CI 0.95–1.20).

Even though the data showed an increased risk of dementia in the first year following celiac diagnosis (HR 1.73; 95% CI 1.15–2.61), the risk did not continue through entire the follow-up period. Moreover, the increased risk was restricted to celiac patients with vascular dementia (HR 1.28; 95% CI 1.00–1.64), and was not present for Alzheimer’s dementia (HR 1.12; 95% CI 0.91–1.37).

Overall, people with celiac disease do not show any increased risk for dementia, though subgroup analysis suggests that they may have a higher risk for vascular dementia.

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