Clinical Section

Coeliac Disease in the Elderly
A Multicentre Italian Study
G. Gasbarrini^a, R. Ciccocioppo^b, I. De Vitis^a, G.R. Corazza<sup>b

a</sup>Department of Internal Medicine, Catholic University of Rome, and
^bDepartment of Gastroenterology, IRCCS Policlinico San Matteo, University of Pavia, Italy

Address of Corresponding Author

Gerontology 2001;47:306-310 (DOI: 10.1159/000052819)

  Key Words

• Coeliac disease
• Death
• Diagnosis
• Elderly

  Abstract

Background: In the last few decades, we have observed either an increased incidence of coeliac disease (CD) or an increased frequency of its diagnosis. However, only scant information is available about the prevalence and clinical features of CD in the elderly. Aim of the Study: To determine the proportion of elderly patients (age 65 years) in a large group of consecutive newly-diagnosed cases of adult CD and to analyze the clinical pattern and causes of death. Patients and Methods: 1,353 adult patients with active CD were diagnosed by 10 Italian Gastroenterology Units over a period of 10 years. For each patient, a questionnaire comprising demographic data, signs and symptoms with their duration at the moment of the diagnosis, and associated diseases or complications and the causes of death, was drawn up. Results: A total of 60 patients (4.4%) were over 65 years at diagnosis with a M/F ratio of 1/2.75 which was similar to 1/2.42 in the under-65-year age group. The mean time of delayed diagnosis was 17 ± 19 years in the elderly and 14 ± 13.8 years in the adults. Classical features of malabsorption were the main presenting symptoms and gastrointestinal disorders were very often also present in the geriatric patients. Twelve aged subjects (20%) died during the follow-up period (mean 4.6 years) often due to cachexia (5%) and heart failure (5%), even though complications such as intestinal lymphoma were present in 8.3% of cases and caused death in 3.3% of the elderly. Conclusions: In spite of classical manifestations of CD in the elderly, the diagnosis was made in only 4.4% of subjects aged over 65 years and the delay was 17 years. These observations, together with the shortening of life expectancy of elderly CD patients, emphasize the importance for clinicians to consider CD as a possible diagnosis and the need for further investigations to be carried out in the elderly general population.

Copyright © 2001 S. Karger AG, Basel

  Author Contacts

Dr. Rachele Ciccocioppo
Dipartimento di Medicina Interna e Sanità Pubblica, Università di L'Aquila
Via San Sisto 22/E
I-67100 L'Aquila (Italy)
Tel. +39 0862 432859, Fax +39 0862 432858

  Article Information

Received: Received: November 20, 2000
Accepted: February 22, 2001
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 3, Number of References : 34