Celiac Disease in Older People: What You Should Know

Celiac disease in older people can occur more often than many think. Keep reading and discover what you need to know about it.
Celiac Disease in Older People: What You Should Know

Last update: 21 January, 2023

Until the late 20th century, celiac disease was thought to be a typical childhood disorder. Our understanding of the disease has changed since then, as we now know that celiac disease in older people is much more common than previously imagined.

Some research even stipulates that 34% of currently diagnosed celiacs are over 60 years old. Given that its symptoms are very different, and that its persistence is irregular, it’s a condition that’s underdiagnosed in the elderly. Let’s discover its clinical manifestations and what we know about its possible complications.

Can celiac disease in older be diagnosed?

The diagnosis of celiac disease in older people can be due to several reasons
If you suffer from a subtype of celiac disease in which the clinical manifestations aren’t so evident, it’s possible to reach old age without a precise diagnosis.

Celiac disease is a disorder that manifests itself, at least in typical cases, with gastrointestinal problems during the first months or years of life. These are triggered after the ingestion of gluten and disappear as soon as this protein is eliminated from the diet.

Due to this, a considerable number of celiac patients reach middle age with the disorder being controlled by a specialist, at least in countries with adequate access to this type of health services.

With this in mind, how is it possible for celiac disease to be diagnosed in older people so late in life? This can have several explanations. Specifically, we’ve chosen the following as the most accepted:

  • Symptoms of the disease don’t always develop in the gastrointestinal area, which can complicate its diagnosis during childhood.
  • There are many variants with no symptoms. For example, we find silent celiac disease and latent celiac disease, two manifestations that don’t give warning signs.
  • Despite advances in their understanding, many doctors aren’t aware of related conditions. Anemia, diabetes, psoriasis, and rheumatoid arthritis often reveal their presence.
  • Patients, especially men, seldom turn to a specialist when symptoms are mild or intermittent.

The sum of all the above can delay the diagnosis of celiac disease in older adults, even when it develops during childhood. The Canadian Society of Intestinal Research also warns us of celiac disease onset in old age. Specifically, it’s a latent celiac disease that doesn’t show up until after the age of 60.

In short, the disorder can occur in older adults, as during this stage, the development of health complications is more frequent, and it’s usually accompanied by other conditions. We’ll talk about that in the next section.

Symptoms of celiac disease in older people

Celiac disease in older people causes dizziness.
Some symptoms, such as dizziness, can become more typical of older adults with celiac disease than of young people.

Based on the available evidence, nonspecific symptoms are particularly common in the elderly. This can make their detection difficult, especially when they don’t develop in the gastrointestinal tract.

The main symptom of the disease in older people is anemia. In fact, some studies suggest that its prevalence can reach 60-80%.

Anemia’s caused by iron deficiency. In this case, the process is triggered because the villi in the intestine are atrophic and can¿t assimilate nutrients from food well. This sign may be accompanied by the following, according to research:

  • Dizziness
  • Constipation
  • Weight gain
  • Folic acid and vitamin B12 deficiency
  • Decrease in bone mass

As you can see, these are signs that are manifested in a good part of the elderly population. Although they’re not special symptoms, their persistence or connection with other conditions can point the way to the disorder. Less frequently, episodes of celiac hepatitis and dermatitis herpetiformis may also develop.

Among the conditions that usually accompany this disorder, we can highlight osteopenia, neurological disorders, and cardiovascular diseases. The incidence of symptoms isn’t usually chronic and their progress is rather slow.

Although there’s evidence that lymphomas are more common in this group of patients, the percentage isn’t that high for alarmist prognoses.

Despite the latter, the Celiac Disease Foundation emphasizes the importance of detecting the condition in later stages. In this way, mechanisms to treat it can be put in place and thus improve the quality of life of patients.

How is celiac disease in older people treated?

As with other age groups, treating celiac disease in older people consists of permanent gluten avoidance. Although this is the protocol recommendation, in practice, various concessions can be made depending on the context.

All this is because many patients will find it difficult to start a gluten-free diet, especially if this protein is part of their daily consumption habits. It’s also important to take into account that if there’s atrophy in the villi, it can take several years to heal after eliminating products with gluten.

Finally, a considerable number of elderly patients with celiac disease don’t develop symptoms that represent a negative setback in their life. This, considering that some, such as dizziness or constipation, have a significant prevalence in healthy populations of their age.

In short, and despite the fact that the elimination of gluten will always be welcome, the specialist may recommend only limiting your intake. The cons of completely discarding its presence in the diet may outweigh its advantages. It wouldn’t be uncommon for symptoms of decompensation to develop by not including a fully balanced intake.

We conclude by suggesting that you seek medical assistance when you suspect that you have the disease. Celiac disease isn’t the only gastrointestinal disorder that can affect older people. Other conditions need to be ruled out when making an objective diagnosis.

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