[Celiac disease in the elderly]

Abstract

Coeliac disease appears at all ages and increasing prevalence in advanced age has been reported. We registered and followed up all coeliac patients during an 11 year period. The article describes the occurrence in elderly persons. Data were collected on symptomatology, laboratory test results, complications, dietary treatment, and progress. A total of 69 coeliacs were registered, giving a crude prevalence of 148/100,000. 13 patients (19%) were 65 years old or older at the time of diagnosis. Mean estimated diagnostic delay in this group was 21.5 years (range 5-40). The symptomatology was uncharacteristic in most patients and not dominated by malabsorption symptoms. Laboratory investigations were generally unhelpful for diagnosis. There was a high frequency of associated disorders, notably malignant diseases. Histology is a sine qua non in the diagnosis of coeliac disease, especially in elderly patients. Wide indications for biopsy are strongly recommended in this age group.