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    How Common is Celiac Disease Diagnosis in the Elderly?


    Jefferson Adams
    Image Caption: Photo: CC--Ethan Prater

    Celiac.com 11/28/2016 - It's clear from research data that what was once thought to be a childhood disease can affect people well into adulthood and old age.


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    A team of researchers recently set out to assess rates of celiac disease diagnosis in an elderly population, recording the main clinical features of this group respect to young patients. The research team included R. Tortora, F. Zingone, A. Rispo, C. Bucci, P. Capone, N. Imperatore, N. Caporaso, D. D'Agosto, and C. Ciacci. They are variously affiliated with the Department of Clinical Medicine and Surgery at the University "Federico II" of Naples in Napes, Italy, and with the Department of Gastroenterology at the University of Salerno in Salerno, Italy.

    They conducted a retrospective analysis of celiac disease rates in elderly individuals from 1970 to 2015. They divided patients by age into three groups. Group A included patients 18-34 years old. Group B included patients 35-64 years old. Group C included patients 65 years or older. The team then compared the groups regarding baseline anthropometric and serological variables, clinical features at diagnosis, diagnostic mode, associated autoimmune diseases, and celiac-related neoplastic complications.

    They made a total of 2,812 celiac disease diagnoses in adults, 2.5% of which occurred in patients 65 years or older at diagnosis. When comparing the three groups, they found no differences in sex, haemoglobin, serum iron, albumin, and anti-tissue transglutaminase (anti-tTG) (p = NS).

    They did find higher values of cholesterol, glycemia, and triglycerides in older patients (p < 0.0001). Elderly had higher rates of diagnosis for malabsorption symptoms compared to younger patients (OR 2.20, 95%CI 1.3-3.74). The team also found no difference in the risk of autoimmune celiac-related diseases between groups. The researchers found 16 neoplastic complications, 13 of them in patients diagnosed with celiac disease between 35-64 years of age.

    The number of celiac disease diagnoses increased over time, particularly in elderly. These results show that celiac disease diagnosis in the elderly population is uncommon, but not rare.

    Elderly celiac patients face a greater risk of being diagnosed with malabsorption symptoms than younger patients, but with a lowr risk of autoimmune and neoplastic complications.

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    Very interesting article...thank you. I'm a home health care provider, and work with the elderly. I often notice anemia and vitamin D deficiencies in medical histories, and wonder about celiac. This answers a question I've had for a while.

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    Sources:
    1. Toft M, Dietrichs E. Aggravated stuttering following subthalamic deep brain stimulation in Parkinson’s disease--two cases. BMC Neurol. 2011 Apr 8;11:44.
    2. Tani T, Sakai Y. Stuttering after right cerebellar infarction: a case study. J Fluency Disord. 2010 Jun;35(2):141-5. Epub 2010 Mar 15.
    3. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    4. Jäncke L, Hänggi J, Steinmetz H. Morphological brain differences between adult stutterers and non-stutterers. BMC Neurol. 2004 Dec 10;4(1):23.
    5. Kell CA, Neumann K, von Kriegstein K, Posenenske C, von Gudenberg AW, Euler H, Giraud AL. How the brain repairs stuttering. Brain. 2009 Oct;132(Pt 10):2747-60. Epub 2009 Aug 26.
    6. Galantucci S, Tartaglia MC, Wilson SM, Henry ML, Filippi M, Agosta F, Dronkers NF, Henry RG, Ogar JM, Miller BL, Gorno-Tempini ML. White matter damage in primary progressive aphasias: a diffusion tensor tractography study. Brain. 2011 Jun 11.
    7. Lundgren K, Helm-Estabrooks N, Klein R. Stuttering Following Acquired Brain Damage: A Review of the Literature. J Neurolinguistics. 2010 Sep 1;23(5):447-454.
    8. [No authors listed] Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1988. A 52-year-old man with persistent watery diarrhea and aphasia. N Engl J Med. 1988 Oct 27;319(17):1139-48
    9. Molteni N, Bardella MT, Baldassarri AR, Bianchi PA. Celiac disease associated with epilepsy and intracranial calcifications: report of two patients. Am J Gastroenterol. 1988 Sep;83(9):992-4.
    10. http://ezinearticles.com/?Food-Allergy-and-Stuttering-Link&id=1235725 
    11. http://www.craig.copperleife.com/health/stuttering_allergies.htm 
    12. https://www.celiac.com/forums/topic/73362-any-help-is-appreciated/
    13. Ford RP. The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29.
    14. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A. Does cryptic gluten sensitivity play a part in neurological illness? Lancet. 1996 Feb 10;347(8998):369-71.

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    Journal of Clinical Pathologyhttp://dx.doi.org/10.1136/jclinpath-2018-205023

    Jefferson Adams
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    Alimentary Pharmacology & Therapeutics