Celiac Disease in Older Adults
Cynthia Grenham works long hours as a real estate agent outside Boston.
But not too long ago, she could not get through many days without taking a nap.
Grenham had other puzzling symptoms, consisting of stomach upset and severe skin inflammation. In some cases her brain felt so foggy, she struggled to discover the right word to express what she wished to say.
Grenham’s father had actually passed away from complications of celiac disease. But she never believed that might discuss her own symptoms.
Celiac Disease in Older Adults
“Nobody picked up on it,” she states. “Nobody evaluated me.”
5 years after her symptoms began, Grenham was finally identified with celiac disease, at the age of 65.
Many people wrongly believe that older adults can’t have celiac disease, which if they do, they can’t gain from treatment, says Alice Bast, creator and president of the Philadelphia-based National Foundation for Celiac Awareness.
But recent research studies reveal that about 2 percent of older adults have celiac disease, which is double the rate for the basic population. Research also shows that the risk for celiac disease increases with age.
“People think, ‘I can’t have celiac disease since I’m too old,'” Bast states. “No matter what age they are, if they have signs, symptoms or member of the family with celiac disease, they need to get checked. It’s crucial.”
A 2009 Mayo Clinic review of current research discovered that 50 is the typical age for a medical diagnosis of celiac disease. But one-third of new patients are diagnosed after age 65.
Daniel A. Leffler, M.D., a gastroenterologist with the Celiac Center at Beth Israel Deaconess Medical Center in Boston, states he and his coworkers routinely identify individuals in their 60s, 70s and even 80s.
“Ten years ago you ‘d need to search everywhere for someone diagnosed over age 60,” Leffler says. “Now it’s quite common.”
Seniors with celiac disease come across an average hold-up in medical diagnosis of 17 years, the Mayo Clinic evaluation found. That’s up to 3 times longer than the delay faced by more youthful peers.
As soon as detected, older grownups with celiac disease face an unique set of obstacles, varying from monetary to social. They may struggle to adjust to — and afford — a gluten-free diet. Limited movement can avoid regular grocery store trips, and stopping working eyesight can make it challenging to check out the fine print on food labels.
Clinically speaking, older adults’ intestinal tracts tend to heal more gradually from damage caused by years of undiagnosed celiac disease, Leffler says.
“The action is not as quick or total as it is for younger individuals,” he says. “They face a tougher road right off the bat.”
However Grenham is proof that senior citizens with celiac disease can live complete and active lives. After following a gluten-free diet for five years, Grenham no longer has skin or neurological issues, and her energy has returned. “I’m a completely changed individual,” she states. “I’m 70 years of ages and get tired at times, however I don’t need to do this 4 o’clock nap thing. I go, go, go.”
Also read: Typical Celiac Disease Symptoms
Getting a medical diagnosis
Research plainly reveals that individuals can establish celiac disease at any age, even if they’ve evaluated negative previously, states Ronni Alicea, a New Jersey signed up dietitian who concentrates on celiac disease and elders.
It’s possible to establish celiac disease as a teenager and not be identified until age 90, she says. A person also could establish symptoms at age 85 and be identified at 86.
There are numerous reasons that seniors might face a hold-up in medical diagnosis. Older adults normally reveal symptoms that are similar to those in younger celiac patients, Leffler says. However the Mayo Clinic evaluation discovered that older adults in some cases show less popular gastrointestinal symptoms and more atypical symptoms as Grenham did.
Older grownups are most likely to have other medical problems, which also can make complex diagnosis, Leffler states. Intestinal symptoms might be triggered by another medical condition or a side effect from a prescription drug. Some symptoms initially might be credited to normal aging.
“It can be confusing to tease out what belongs to celiac disease when an individual has other medical issues,” he says.
For people who’ve suffered symptoms for a very long time, a celiac disease diagnosis can come as a relief, Leffler states. But someone who’s had symptoms for 30 years might also feel annoyed that their fairly straightforward issue took so long to identify. Seniors who are recently detected must not stress, Leffler says.
“Almost everyone diagnosed has actually had [celiac disease] for a long period of time,” he says. “Realize it’s not an emergency situation. It takes some time. Nobody gets the gluten-free diet right overnight.”
Remaining favorable can make a huge difference, Bast says. Concentrate on the foods you can eat, not the ones that are now off-limits. Bast satisfied one man who was identified at age 93. Once he adjusted to the gluten-free diet, he said he felt 20 years more youthful.
“You can feel better and improve your lifestyle at any age,” she states.
Successfully handling celiac disease as an older adult requires assistance from a multidisciplinary group. Connecting with specialists and a great support group can assist seniors feel better and remain independent, Bast states.
“You have to promote for yourself,” she says. “Be empowered and not embarrassed. Ask for aid.”
Your doctor and a registered dietitian with proficiency in celiac disease can supply guidance through the transition to a gluten-free diet. Seniors who reside in a retirement home should meet with the nutrition professional on personnel.
Clear the pantry and refrigerator of gluten. Then inspect the medication cabinet.
“Seniors have the tendency to take a lot more medications,” Bast states. “In addition to gluten remaining in food, it can likewise be hiding in your medications.”
Although most prescriptions are gluten complimentary, inning accordance with Steve Plogsted, a pharmacist at Columbus Children’s Hospital, a few are not. Gluten is used as a filler in some drugs. Since these non-active active ingredients do not need to be noted on prescription labels, it can be difficult to figure out which drugs include gluten. Also inactive components can alter and the same ones are not used from producer to manufacturer of a medication. That implies seniors have to inspect all medications routinely. Leffler advises referring to Plogsted’s website, glutenfreedrugs.com, which is commonly recognized as the best source of info about gluten in drugs. Plogsted also composes a repeating column in Gluten-Free Living which addresses readers’ medication concerns.
Securely handling medications can be frustrating for an older adult with celiac disease, particularly if there is amnesia, Bast says. That’s why it’s crucial to have a pharmacist on your team. Set up a meeting to evaluate your medications and determine any possible problems.
Elders who are “shopping” for a retirement community need to choose one where the cooking area personnel is trained and gluten-free procedures are in place, Bast states. Preferably the neighborhood will have a registered dietitian and pharmacist on personnel.
“You want to make sure if you are going to live somewhere, that you can eat and be accommodated, especially if you’re not as mobile,” she says.
Alicea, the R.D., suggests that seniors meet with the food service director at any potential brand-new home. Ask if the staff has actually handled a gluten-free diet prior to or if they are willing to learn. Don’t stop there.
“Ask to speak to other gluten-free locals,” she states. “They’ll be the ones to tell you what’s really going on.”
At one neighborhood, Alicea fulfilled 7 homeowners with celiac disease. None were happy with the kitchen’s gluten-free offerings, a great indicator the home was not an excellent option for somebody looking for gluten-free lodgings.
Elders who choose to move shouldn’t choose a handshake, Alicea says. Make sure the community’s pledge to provide gluten-free meals is noted in your contract.
Following the diet
Numerous seniors embrace the shift to a gluten-free diet because they feel so much better. Others are intimidated about attempting something new.
Freshly detected senior citizens may be reluctant to modify a life time of dietary habits, Leffler states. In basic, the longer you do anything, the more difficult it is to alter.
“When you’ve been eating a certain way for 50, 60, 70 years and you all of a sudden have to make significant changes to what you can eat, that can be extremely distressing,” he states.
Following a new diet can be especially challenging for older grownups with amnesia, Alicea states. Those with dementia, in particular, require close guidance.
Some recently detected seniors may choose they would rather deal with celiac symptoms than alter their diet. But, Alicea states, “The repercussion for not following the diet is you’re just not as healthy.”
Needing to follow a special diet can result in a sense of seclusion, specifically for homebound elders. Eating in restaurants or going to social events that involve food might not appear worth the effort. Celiac disease support groups can be a terrific source of friendship for older adults, Alicea says.
When Grenham, the Massachusetts realtor, was first identified, her partner approached her brand-new diet with caution. She initially prepared one meal for herself and another for him.
Now that Grenham is more knowledgeable at cooking gluten-free meals, she and her partner eat the same meals about 95 percent of the time. He still won’t eat gluten-free bread, and she doesn’t blame him.
“We eat extremely well,” she states. “I constantly wish to show people it’s not that tough.”
Also read: Celiac Disease Diet
Keeping expenses in check
Grenham deals with newly identified celiac disease patients through her support group, the Healthy Villi. She often takes her brand-new friends to the supermarket and points out gluten-free products that are worth the cash.
No matter what their age, many who are newly detected experience sticker label shock, Grenham says. However the cost of a gluten-free diet can be especially challenging for elders on a fixed income.
“It’s very, really expensive. There are no two ways about it,” she says, noting a loaf of bread can cost $7 and a pound of pasta $4.
Grenham advises websites such as Gluten Free Saver and Gluten Free Mall to people with minimal spending plans or movement.
Elders who have problem getting to the supermarket on a regular basis can make it easier on themselves with some easy replacements, Bast says. For example, canned vegetables, which cost less and keep longer, can be a great option to fresh.
Family or friends of an older adult with celiac disease need to sign in routinely to make sure their enjoyed one’s kitchen area is equipped with nutritious gluten-free foods, she states.
Seniors with celiac disease can effectively manage their diet without ever buying more costly ready-made gluten-free products, Alicea points out.
“If you can’t manage to purchase processed [foods], you’re not going to starve,” she says. “Naturally gluten-free foods are plentiful.”
Some older adults depend on senior centers or Meals on Wheels for food. Social service agencies presently aren’t needed to offer gluten-free food, and many do not have the resources to do so, Alicea says.
The roadway to recovery
Recovery often comes more slowly for seniors with celiac disease, Leffler states. Healing usually slows with age, and numerous older adults unconsciously had celiac disease for many years before medical diagnosis.
“Clearly the older you are, the more medical issues you have, and the more difficult it is for the intestinal tracts to recover from celiac disease,” Leffler says.
Senior citizens usually have the same associated conditions that can afflict celiac patients of any ages, he says. Age and a delay in diagnosis often can lead to more serious conditions, including autoimmune conditions and some cancers.
Seniors with a delayed diagnosis are likely to have longstanding nutritional shortages, Alicea states, especially involving absorption of nutrients. This can lead to conditions such as bone disease and anemia, and typically calls for additional supplements.
Senior citizens who are diagnosed however still have stomach pain or diarrhea ought to not presume that celiac disease is to blame, she states. Another condition, such as lactose intolerance or diverticulitis, might be the perpetrator.
“People blame celiac disease and often don’t seek medical attention when they should,” Alicea states.
Considering that her celiac diagnosis, Grenham has established multiple food allergies, consisting of to fresh fruit and shellfish. She eats in restaurants only when she absolutely can’t avoid it. When she checks out good friends or next-door neighbors, she brings her own food.
“I need to be incredibly mindful,” Grenham states. “Fortunately something I’m not adverse is wine.”
Equipped with a glass of red and a box of gluten-free crackers, she can take on any difficulty.
Last modified: March 22, 2017