title: Celiac disease: similar presentations in the elderly and young adults.
abstract: OBJECTIVE
  Studies have shown that celiac disease can affect individuals in all age groups. However, few studies have described the disease in the elderly. The goal of this study is to characterize celiac disease in the elderly by comparing to a population of young adults with celiac disease.
  
  
  METHODS
  Review of a tertiary center database of patients with celiac disease was performed to identify two groups of patients, an elderly cohort ≥ 65 years and a young adult cohort aged 18-30 years, with biopsy-confirmed celiac disease. Information obtained included symptom duration, clinical presentation, small intestinal pathology, associated conditions, and the presence of bone disease.
  
  
  RESULTS
  Included in the study were 149 young adult and 125 elderly patients; the latter represented 12.4% of the patients in our database. The duration of symptoms prior to diagnosis was similar, 5.8 ± 12 years and 6.14 ± 12.6 years in the young adult and elderly cohorts, respectively (p = 0.119). There was no significant difference in the mode of presentation of illness. Diarrhea was the main presenting symptom (49% in young adults vs. 50% in the elderly, p = 0.921). There was a similar prevalence of autoimmune disease (19% in young adults vs. 26% in the elderly, p = 0.133). Thyroid disease and neuropathy were more prevalent in the elderly (p = 0.037 and p = 0.023, respectively). The degree of villous atrophy and prevalence of bone disease were similar in each group.
  
  
  CONCLUSIONS
  Surprisingly, the presentation of celiac disease both clinically and histologically is similar in elderly and young adult patients. The factors triggering disease at any given age remain unclear and warrant further study.
authors.affiliation: Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA. rum9016@nyp.org
authors.forename: Rupa
authors.initials: R
authors.lastname: Mukherjee
authors.forename: Ikenna
authors.initials: I
authors.lastname: Egbuna
authors.forename: Pardeep
authors.initials: P
authors.lastname: Brar
authors.forename: Lincoln
authors.initials: L
authors.lastname: Hernandez
authors.forename: Donald J
authors.initials: DJ
authors.lastname: McMahon
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Shane
authors.forename: Govind
authors.initials: G
authors.lastname: Bhagat
authors.forename: Peter H R
authors.initials: PH
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D001327:Autoimmune Diseases / Q000453:epidemiology; D001851:Bone Diseases, Metabolic / Q000453:epidemiology; D002446:Celiac Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000453:epidemiology; D013959:Thyroid Diseases / Q000453:epidemiology; D055815:Young Adult