title: Cognitive performance is impaired in coeliac patients on gluten free diet: a case-control study in patients older than 65 years of age.
abstract: BACKGROUND
  Retrospective studies and case reports suggest an association between coeliac disease and impaired cognitive function.
  
  
  OBJECTIVE
  To evaluate functional and cognitive performances in coeliac disease vs. control patients older than 65 years.
  
  
  METHODS
  Eighteen coeliac disease patients (75±4 years, group A) on gluten free diet since 5.5±3 years and 18 age-sex matched controls (76±4 years, group B) were studied using a battery of neuropsychological tests. Results of functional and cognitive tests are expressed as "row scores" and as "equivalent scores" by relating "raw scores" to reference rank categories.
  
  
  RESULTS
  Barthel Index of functional performance was similar in the 2 groups. "Raw score" was significantly lower in coeliac disease than controls for Mini Mental Test Examination (p=0.02), Trail Making Test (p=0.001), Semantic Fluency (p=0.03), Digit Symbol Test (p=0.007), Ideo-motor apraxia (p<0.001) and Bucco-facial apraxia (p<0.002). "Equivalent score" was also lower in coeliac disease than controls for Semantic memory (p<0.01) and for Ideo-motor apraxia (p=0.007).
  
  
  CONCLUSIONS
  Cognitive performance is worse in elderly coeliac disease than control patients, despite prolonged gluten avoidance in coeliacs. Awareness on the increasing phenomenon of late-onset coeliac disease is important to minimize diagnostic delay and prolonged exposure to gluten that may adversely and irreversibly affect cognitive function.
authors.affiliation: Gastroenterology Unit, Department of Medicine, University and Spedali Civili, Brescia, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Casella
authors.forename: Barbara
authors.initials: B
authors.lastname: Zanini
authors.forename: Francesco
authors.initials: F
authors.lastname: Lanzarotto
authors.forename: Chiara
authors.initials: C
authors.lastname: Ricci
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marengoni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Romanelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Lanzini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies / Q000097:blood; D020240:Apraxia, Ideomotor / Q000209:etiology / Q000523:psychology; D001072:Apraxias / Q000209:etiology* / Q000523:psychology; D001288:Attention; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy* / Q000523:psychology*; D003071:Cognition; D055050:Diet, Gluten-Free; D005260:Female; D019204:GTP-Binding Proteins; D006801:Humans; D008297:Male; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011930:Reaction Time; D012189:Retrospective Studies; D014145:Trail Making Test; D011503:Transglutaminases / Q000276:immunology
chemical_list: D000906:Antibodies; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins