You are never too old to get celiac disease, study shows

The number of people in the US who have celiac disease has been doubling every 15 years, with most of the increase found among the elderly, according to a new study released today.

Researchers at the University of Maryland's Center for Celiac Research looked at blood tests of 3,511 people and found that one in 501 were positive for celiac disease in 1974, increasing to one in 219 in 1989. As people in the study aged, the incidence of celiac disease rose, according to  results published in the online version of The Annals of Medicine. The CFCR's landmark study into the prevelance of celiac disease in 2003 put the number at one in 133.

Carlo Catassi, MD, lead author and co-director of the CFCR, said you are not necessarily born with celiac disease and urged physicians to screen their elderly patients. The new research echoes the results of a 2008 Finnish study that found the prevalence of celiac disease in the elderly is nearly two and a half times higher than in the general population.

"You are never too old to develop celiac disease," said Alessio Fasano, MD, director of the CFCR.

Fasano said the study shows that environmental factors cause a person to stop being able to tolerate gluten at some point in their lifetime. If individuals can tolerate gluten for many decades before developing celiac disease, something other than gluten must be in play, Fasano said.

If those factors could be identified and manipulated, new treatments and prevention of celiac disease would be possible, he said.  Researchers have already identified specific genetic markers for the development of celiac disease, but these markers do not guarantee that an individual will eventually get it. How and why someone loses tolerance to gluten remains a mystery.

The increase in celiac diagnosis in the elderly also calls into question the assumption that celiac disease usually develops in childhood.

The study was based on blood samples from more than 3,500 adults who were followed over time. The Universita Politecnica delle Marche in Ancona, Italy, the Johns Hopkins Bloomberg School of Public Health, the Women & Children's Hospital of Buffalo and Quest Diagnostics also participated.