Living Gluten-Free for Older Adults
If you are a senior citizen or have family members or friends who are 65 or older, here’s what you—or they—need to know about gluten-related disorders.
People of all ages experience celiac disease or non-celiac gluten sensitivity. Gluten-related disorders present different issues depending on one’s life stage. Being an older adult means that some of your symptoms, or the effects of these disorders, could be different from someone younger.
Let’s look at some of the issues to keep in mind for older adults.
There is no age limit for developing celiac disease.
Celiac disease can develop at any age, from infancy to older adulthood. Three factors need to be present for the condition to develop:
- The predisposing genes must be present,
- Gluten must be a regular part of the diet; and,
- A triggering event or circumstance needs to occur or be present.
Scientists are actively exploring what the “triggering” events or circumstances could include because they are not completely defined. A triggering event could be an accident, surgery, or another stressful event, something that can occur at any age, including in older adulthood. When and how someone develops celiac disease can be complicated. Diagnosing celiac disease can also be challenging, even for older adults.
Diagnosing celiac disease is not always easy.
It is possible that an older individual has been living with celiac disease for some time, perhaps without severe obvious symptoms, and is only recently diagnosed. Diagnosing celiac disease can be elusive regardless of age. There are over 200 symptoms associated with the condition, and many of the symptoms are also associated with other conditions. The diverse and numerous symptoms of celiac disease may be masked by—or can mimic—symptoms of other conditions. Add to that the fact that senior citizens are more likely to develop other chronic health conditions, and it makes sense why celiac disease may not be looked for, or missed, in this population group.
Untreated celiac disease is detrimental to your health.
Undiagnosed or untreated celiac disease can have serious health consequences. Among the potential consequences of celiac disease for older adults are poor bone health (osteopenia or osteoporosis), weight loss, anemia, and if left untreated, a higher risk of some cancers.
As people age, some processes involved with absorbing nutrients become impaired. In undiagnosed or untreated celiac disease, the intestinal cell damage caused by gluten hinders nutrient absorption, amplifying nutrient-related issues. Some older adults may not be able to absorb enough vitamin B12, and their need for calcium may increase, for example. Nutrient deficiencies could become more pronounced in older adults with untreated or undiagnosed celiac disease.
Because autoimmune conditions like celiac disease have a genetic component, when one is present, the risk of developing others increases. Some older adults may receive a celiac disease diagnosis after receiving a different autoimmune disease diagnosis.
Non-celiac gluten sensitivity (NCGS) may also develop in later adulthood. The symptoms largely overlap with those of celiac disease, however, NCGS is not an autoimmune condition. NCGS also does not impact nutrient absorption. NCGS is still poorly defined and not completely understood. A diagnosis of NCGS might be made if celiac disease, wheat allergy, and other possible causes of an older adult’s symptoms are ruled out, and if a gluten-free diet alleviates those symptoms.
Additional considerations for senior citizens living gluten-free
There are other factors related to aging that can make eating gluten-free more challenging than what younger people may experience.
Caloric needs are generally reduced as we age. Muscle mass decreases, and activity levels often do too. This means that it’s even more important to choose nutrient-dense foods to get all the necessary nutrients in a smaller amount of food and calories. Many gluten-free foods tend to be lower in micronutrients than their gluten-containing counterparts which can further impact nutrient intake. As an older adult, choosing nutrient-dense foods when eating gluten-free is especially important.
Older adults may experience reduced appetite, and/or face circumstances such as social isolation, physical impairments, or fixed incomes that lead to reduced food intake, further amplifying potential issues of nutrient insufficiencies.
Mental impairment due to the aging process, or a lack of focus or concern, could mean that an older adult may pay less attention to avoiding gluten. Continued gluten intake after a celiac disease diagnosis will cause further intestinal damage, exacerbate symptoms, and could lead to the development of additional serious health issues.
Older adults are more likely to be on medications and supplements, which should be monitored for gluten content, adding another layer of complexity and challenge to living gluten-free.
If they are in an assisted living facility, there may be limited options for gluten-free foods. Not all staff at assisted living facilities know about the gluten-free diet and the facility may not be suitable for properly preparing and serving gluten-free foods.
Some older adults may receive help from others to prepare or supply meals, such as neighbors, friends, and family members. While this can be very helpful, in theory, it also introduces the risk of exposure to gluten if these individuals do not know how to provide food that is safely gluten-free.
Eating gluten-free is essential for anyone diagnosed with celiac disease or NCGS. Older adults could experience additional challenges in adopting and adhering to a gluten-free diet. These challenges could lead to symptoms and health issues caused by continued exposure to gluten, and/or potentially insufficient intake of foods and nutrients because of all these factors. Paying close attention to, and addressing, these issues can help ensure older adults have access to nutrient-dense gluten-free meals and the support they need to maintain a gluten-free diet.
For additional information, see the table in our article, Ages and Stages of Celiac Disease listing symptoms by life stage. Also see our article, Senior Care: Gluten-Free Living for Our Elders for information about assisted living facilities and Medications and the Gluten-Free Diet for assistance in determining the gluten-free status of medications.
The information on this website is for educational purposes only. Consult your healthcare team when considering this information.
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