Lactose malabsorption and intolerance in the elderly

Background: Lactase activity declines with age in rats, but it is not clear whether this model is also shared by humans. Few studies have evaluated la ctose intolerance and malabsorption in the elderly and no definite conclusi ons can be drawn. The aim of our study was therefore to verify the impact o f age on lactose intolerance and malabsorption. Methods: Eighty-four health y subjects took part in the study. Thirty-three were < 65 years, 17 were be tween 65 and 74 years and 34 were > 74 years. All the subjects underwent a preliminary evaluation of intestinal gas production capacity and oro-cecal transit time by H-2/CH4 breath test after lactulose. After a 3-day period, an H-2/CH4 breath test after lactose was per-formed. The occurrence of into lerance symptoms during the test and in the 24 li after the test was record ed. Results: Breath H-2 and CH4 excretion parameters at fasting and after l actulose did not differ between the three groups. Cumulative breath H-2 exc retion after lactose was higher in subjects > 74 years than in subjects < 6 5 years and in subjects aged 65-74 years, while no difference was found bet ween the latter two groups. In subjects > 74 years, the prevalence of lacto se malabsorption was higher than in the other two groups, while no signific ant difference was observed between subjects < 65 years and subjects a.-ed 65-74 years. Within the malabsorber subjects, the prevalence of lactose int olerance was higher in subjects < 65 years than in those aged 65-74 years a nd in those aged > 74 years. No significant difference was found between th e latter two groups. No difference was found between the three groups in te rms of daily calcium intake and a significant negative correlation between symptom score and daily calcium intake was only found in the group of subje cts aged < 65 years. Conclusions: As age increases, the prevalence of lacto se malabsorption shows an increase while the prevalence of intolerance symp toms among malabsorbers shows a decrease. Accordingly, daily calcium intake was similar among the adults and elderly studied.