Background. In the last few decades, we have observed either an increased i
ncidence of coeliac disease (CD) or an increased frequency of its diagnosis
. However, only scant information is available about the prevalence and cli
nical features of CD in the elderly. Aim of the Study. To determine the pro
portion of elderly patients (age greater than or equal to 65 years) in a la
rge group of consecutive newly-diagnosed cases of adult CID and to analyze
the clinical pattern and causes of death. Patients and Methods: 1,353 adult
patients with active CID were diagnosed by 10 Italian Gastroenterology Uni
ts over a period of 10 years. For each patient, a questionnaire comprising
demographic data, signs and symptoms with their duration at the moment of t
he diagnosis, and associated diseases or complications and the causes of de
ath, was drawn up. Results: A total of 60 patients (4.4%) were over 65 year
s at diagnosis with a M/F ratio of 1/2.75 which was similar to 1/2.42 in th
e 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 featur
es of malabsorption were the main presenting symptoms and gastrointestinal
disorders were very often also present in the geriatric patients. Twelve ag
ed subjects (20%) died during the follow-up period (mean 4.6 years) often d
ue 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 CID
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 importa
nce 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 (C) 2001 S. Karger AG, Basel.