Older Adults with Celiac Disease Have Increased Risk of Frailty: Study

A new Swedish study published in the American Journal of Gastroenterology revealed that older adults diagnosed with celiac disease (CeD) are significantly more prone to frailty when compared to their peers without the condition. The nationwide cohort study examined individuals aged 60 and older diagnosed with CeD between 2004 and 2017 and matched them with non-CeD controls of similar age, sex, and location. The findings illuminate the heightened vulnerability faced by older adults with CeD by raising concerns about the long-term health impacts of the disease.

This research analyzed frailty levels within 3 years prior to diagnosis using the Hospital Frailty Risk Score, a tool that stratifies individuals into low, intermediate, and high frailty risk categories. Of the 4,646 CeD patients included, 54.4% were classified as frail at baseline when compared to 29.7% of the 21,944 matched controls. Also, frailty was more prevalent across all categories for CeD patients where 43.4% were at low-risk when compared to 23.8% of controls, 10.3% were at intermediate-risk when compared to 5.4%, and 0.8% were at high-risk versus 0.6% among controls.

For individuals without baseline frailty, this study found a stark 66% increased likelihood of developing frailty over the subsequent 5 years for the individuals with CeD. This translated to a significantly higher risk of functional decline and potential complications in this population.

This study also explored the role of mucosal healing where follow-up biopsies that indicated mucosal healing did not correlate with a reduced risk of frailty by suggesting that frailty in older CeD patients may be driven by broader systemic effects of the disease rather than localized gut damage alone. The study suggests that frailty, characterized by decreased resilience and increased susceptibility to adverse health outcomes, poses challenges ranging from reduced mobility to higher risks of hospitalization and mortality.

Overall, this study highlights the need for further research into the mechanisms linking CeD and frailty, as well as interventions tailored to the unique needs of older patients. Proactive measures such as comprehensive care plans and targeted therapies may help manage frailty risk and improve the quality of life for this patient popult.

Source:

Zylberberg, H. M., Lebwohl, B., Söderling, J., Kochar, B., Jylhävä, J., Green, P. H. R., & Ludvigsson, J. F. (2024). Older Adults with Celiac Disease Are At Increased Risk of Frailty:A Nationwide Cohort Study. In American Journal of Gastroenterology. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.14309/ajg.0000000000003217