Frailty Risk Increased in Older Adults With Celiac Disease

TOPLINE:

Older adults with celiac disease (CeD) face a higher risk of developing frailty within 5 years than those without the condition, a finding that indicates the need for targeted interventions.

METHODOLOGY:

• Researchers used data from Swedish healthcare registries to a conduct nationwide retrospective cohort study that investigated the risk for frailty and its prevalence between 2004 and 2017.
• They matched 4646 people aged 60 years or older diagnosed with CeD (mean age at diagnosis, 71 years; 52% women) with 21,944 control individuals without the condition. Additionally, siblings of individuals with CeD were identified through registry linkage as secondary controls.
• Researchers assessed frailty at baseline, defined as within 3 years before diagnosis or index date, using the Hospital Frailty Risk Score (HFRS) and at 1, 3, and 5 years post-diagnosis. A score of 0 is classified as no risk, > 0-4 is low risk, 5-15 is intermediate risk, and > 15 is high risk.
• Further analysis compared the risk for frailty between patients with CeD who achieved mucosal healing (n = 530) and those with persistent villous atrophy (n = 447), as determined by follow-up biopsy.

TAKEAWAY:

• At baseline, frailty (HFRS ≥ 1) was present in 54.4% of older adults with CeD, compared with only 29.7% of matched controls (odds ratio [OR], 2.91; P
• Among patients who were not frail at baseline, an increased risk for frailty (HFRS > 0) at 5 years was seen in 53.6% of patients with CeD, compared with 41.1% of controls. The risk for high-risk frailty was substantially elevated in patients with CeD, particularly in women.
• Those with CeD also exhibited a higher risk for frailty than their siblings without the condition (adjusted OR, 1.73; P
• The risk for frailty did not differ between those with CeD who achieved mucosal healing and those with persistent villous atrophy.

IN PRACTICE:

“Older patients with CeD [celiac disease] may…be a particularly vulnerable group who may benefit from targeted frailty-related management and dedicated gastroenterology and nutrition services,” the authors wrote. “By identifying patients with CeD who have frailty, providers may be able to develop more targeted interventions in the management of older adults with CeD.”

SOURCE:

The study, led by Haley M. Zylberberg, MD, Columbia University College of Physicians and Surgeons, New York City, was published online in The American Journal of Gastroenterology.

LIMITATIONS:

The small sample size in the high-risk frailty group may have limited the reliability of interpretations for specific frailty risk categories. Data on factors influencing frailty, including alcohol consumption, smoking status, mental health, and history of osteoporosis, were not available. The retrospective study design restricted the inclusion of a serological diagnosis of CeD. The inability to assess adherence to a gluten-free diet may have affected the evaluation of mucosal healing.

DISCLOSURES:

One author disclosed coordinating a study funded by a pharmaceutical company, receiving financial support from a biopharmaceutical company to develop a paper, and having an ongoing collaboration on CeD. Another author reported receiving financial support through a program funded by a pharmaceutical company. Another author reported receiving a grant from the National Institute on Aging and support from pharmaceutical companies that had ended by the time this study was conducted.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.