Older adults with celiac disease face a unique set of challenges, ranging from financial to social. It can be difficult to adapt to – and afford – a gluten-free diet. Limited mobility can prevent frequent grocery store trips, and failing eyesight can make it difficult to read the small print on food labels.
But seniors who are newly diagnosed should not panic. It takes time. Nobody gets the gluten-free diet right overnight. Staying positive can make a big difference. Focus on the foods you can eat, not the ones that are now off-limits.
The risk for celiac disease rises with age. About 2 percent of older adults have celiac disease, which is double the rate for the general population.
About one-third of new celiac disease patients are diagnosed after the age of 65. Still, seniors with celiac disease have an average delay of 17 years getting diagnosed – three times longer than younger peers.
Any senior who has symptoms of celiac disease (you’ll find a list here) or who has a family member with celiac disease should be tested.
Older adults usually show symptoms that are similar to those in younger celiac patients, but older adults sometimes show less prominent gastrointestinal symptoms and more atypical symptoms which can delay diagnosis. Older adults are more likely to have other medical problems, which also can complicate diagnosis. And seniors sometimes mistakenly attribute signs of celiac disease to the aging process.
Celiac disease affects the bones and skeleton. Osteoporosis, a disease in which bones become weakened, thin and brittle, can result from celiac disease. Those who have celiac disease have a 3.5 percent chance of being diagnosed with osteoporosis compared to only .05 percent in the general population. They also have double the risk of bone fractures.
Seniors with celiac disease should consider being tested for osteoporosis. Osteoporosis can be successfully treated, and the treatments can help slow down bone loss and prevent fractures.
As well as being prone to malnutrition, celiac disease patients do not absorb enough calcium and Vitamin D to build strong bone and prevent it from weakening. Because they don’t absorb the nutrients from food, they can also be underweight, another risk factor for osteoporosis.
Osteoporosis in celiac disease patients can often be prevented or improved with a gluten-free diet. A gluten-free diet and calcium with Vitamin D supplementation may be sufficient to strengthen the patients’ bones and enable the patients to absorb the nutrients they need to prevent osteoporosis. Weight-bearing exercise is also beneficial for prevention.
Recovery often comes more slowly for seniors with celiac disease. Healing generally slows with age, and many older adults unknowingly had celiac disease for years before diagnosis.
Seniors generally have the same associated conditions that can afflict celiac patients of all ages. Age and a delay in diagnosis sometimes can lead to more serious conditions, including autoimmune disorders and some cancers.
Seniors with a delayed diagnosis are likely to have longstanding nutritional deficiencies, particularly involving absorption of nutrients. This can lead to conditions such as bone disease and anemia, and often calls for extra supplements.
Seniors who are diagnosed but still have stomach pain or diarrhea should not assume that celiac disease is to blame. Another condition, such as lactose intolerance or diverticulitis, could be the culprit.
Successfully managing celiac disease as an older adult requires support from a multidisciplinary team. Connecting with professionals and a good support group can help seniors feel better and stay independent.
Your doctor and a registered dietitian with expertise in celiac disease can provide guidance through the transition to a gluten-free diet. Seniors who live in a retirement community should meet with the nutrition professional on staff.
Having to follow a special diet can lead to a sense of isolation, especially for homebound seniors. Dining out or attending social events that involve food might not seem worth the effort. Celiac disease support groups can be a great source of companionship for older adults.
Start by clearing the pantry and refrigerator of gluten. Then check the medicine cabinet. In addition to gluten being in food, it can also be found in your medications. Although most prescriptions are gluten free, a few are not. Gluten is used as a filler in some drugs, but does not have to be listed on prescription labels so it can be difficult to determine which drugs contain gluten. That means seniors have to check all medications regularly. Refer to GlutenFreeDrugs.com for more information, and set up a meeting with your pharmacist to review your medications and identify any potential problems
The cost of a gluten-free diet can be especially burdensome for seniors on a fixed income. Websites such as Gluten Free Saver and Gluten Free Mall offer solutions to people with limited budgets or mobility. Seniors who have trouble getting to the grocery store on a regular basis can use some simple substitutions. For example, canned vegetables, which cost less and keep longer, can be a good alternative to fresh. Seniors with celiac disease can successfully manage their diet without ever buying more expensive ready-made gluten-free products. Naturally gluten-free foods are abundant.
Family or friends of an older adult with celiac disease should check in regularly to make sure their loved one’s kitchen is stocked with nutritious gluten-free foods.
Seniors should choose retirement communities where the kitchen staff is trained and gluten-free protocols are in place. Ideally the community will have a registered dietitian and pharmacist on staff. Seniors should meet with the food service director at any prospective new home. Ask if the staff has handled a gluten-free diet before or if they are willing to learn. Speak to other gluten-free residents as well. Make sure the community’s pledge to provide gluten-free meals is noted in your contract.
A growing number of retirement communities now have experience working with seniors on a gluten-free diet. GenCare Lifestyle, with four locations in Washington state and two in Arizona, is the nation’s first retirement community to attain Gluten-Free Food Service accreditation.
This material is not intended to provide medical advice, which should be obtained directly from a physician.