Reviews in Clinical Gerontology

Clinical geriatrics

Coeliac disease in the older person

Stephanie M Robinsona1, Ramona McLoughlina2 and Shaun T O'Keeffea1 c1

a1 Department of Geriatric Medicine, Galway University Hospitals, Galway, Ireland

a2 Department of Gastroenterology, Galway University Hospitals, Galway, Ireland

Summary

Coeliac disease (CD) results from immunologically mediated inflammation of the small intestinal mucosa precipitated by ingestion of gluten in wheat and other cereals in genetically susceptible people. There is a broad spectrum of clinical and histological features associated with gluten sensitivity. Overt clinical malabsorption is uncommon, and clinical symptoms are often non-specific. This is particularly true of older people and the diagnosis of CD may be delayed or missed as a result. The incidence of metabolic bone disease, neurological symptoms and nutritional deficiencies are high in older people with CD and respond well to treatment. Sensitive and specific serological tests are now available and these have improved ease of detection of CD in patients without classical symptoms. Hence, a high index of suspicion is warranted in older people with potential symptoms of CD.

(Online publication October 12 2012)

Key words:

  • coeliac disease;
  • older people;
  • gluten sensitivity;
  • malabsorption;
  • metabolic bone disease;
  • anaemia

Correspondence:

c1 Address for correspondence: Dr S. O'Keeffe, Unit 4, Merlin Park University Hospital, Galway, Ireland. Email: sokanc@iolfree.ie