Celiac Disease Rates Rising With More Cases in Elderly
Author: University of Maryland Medical Center
Published: 2010/09/27 - Updated: 2026/02/25
Publication Type: Research, Study, Analysis
Category Topic: Autoimmune Diseases - Related Publications
Contents: Synopsis - Introduction - Main - Insights, Updates
Synopsis: This research, conducted by the University of Maryland School of Medicine Center for Celiac Research in collaboration with the Universita Politecnica delle Marche in Italy, Johns Hopkins Bloomberg School of Public Health, and others, was published in the peer-reviewed journal Annals of Medicine. Using blood samples from more than 3,500 adults tracked over decades, the study found that celiac disease incidence in the United States has doubled every 15 years since 1974, rising from one in 501 to one in 219 by 1989, with cases continuing to increase - particularly among the elderly. The findings challenge the long-held assumption that celiac disease develops primarily in childhood and suggest that environmental factors beyond gluten play a role in triggering autoimmunity. This is especially important for seniors, people with disabilities, and those living with autoimmune conditions, as it points toward the possibility of identifying preventable triggers not only for celiac disease but for related disorders such as type 1 diabetes, rheumatoid arthritis, and multiple sclerosis - Disabled World (DW).
- Topic Definition: Celiac Disease
Celiac disease is a chronic autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye, in which the body's immune system attacks the lining of the small intestine, leading to nutrient malabsorption and progressive intestinal damage. Classic symptoms include diarrhea, abdominal bloating, and stomach cramps, though atypical presentations such as joint pain, chronic fatigue, and depression are common and contribute to widespread underdiagnosis. Research from the University of Maryland Center for Celiac Research has shown that the incidence of celiac disease in the United States has doubled roughly every 15 years since 1974, with a notable increase in cases developing among older adults, challenging the long-standing assumption that the disease originates primarily in childhood. Although specific genetic markers are associated with celiac disease, environmental factors beyond gluten itself appear to play a critical role in determining when or whether an individual loses tolerance to the protein.
Introduction
Research Finds Rate of Celiac Disease is Growing
UM School of Medicine Center for Celiac Research finds rate of celiac disease is growing - Study finds increasing number of celiac cases, particularly in the elderly.
Working to solve the puzzle of when people develop celiac disease has led researchers from the University of Maryland School of Medicine Center for Celiac Research to some surprising findings. They have found that the autoimmune disorder is on the rise with evidence of increasing cases in the elderly. An epidemiological study published September 27 in the Annals of Medicine supports both trends with interesting implications for possible treatment and prevention.
"You're never too old to develop celiac disease," says Alessio Fasano, M.D., director of the University of Maryland's Mucosal Biology Research Center and the celiac research center, which led the study.
Main Content
The Universita Politecnica delle Marche in Ancona, Italy; the Johns Hopkins Bloomberg School of Public Health; the Women & Children's Hospital of Buffalo; and Quest Diagnostics Inc. of San Juan Capistrano, Calif., also participated.
Celiac disease is triggered by consuming gluten, a protein found in wheat, barley and rye. Classic symptoms include diarrhea, intestinal bloating and stomach cramps. Left untreated, it can lead to the malabsorption of nutrients, damage to the small intestine and other medical complications.
Since 1974, in the U.S., the incidence of the disorder has doubled every 15 years. Using blood samples from more than 3,500 adults, the researchers found that the number of people with blood markers for celiac disease increased steadily from one in 501 in 1974 to one in 219 in 1989. In 2003, a widely cited study conducted by the celiac research center placed the number of people with celiac disease in the U.S. at one in 133.
As the people in the study aged, the incidence of celiac disease rose, echoing the findings of a 2008 Finnish study in Digestive and Liver Disease that found the prevalence of celiac disease in the elderly to be nearly two and a half times higher than the general population. The recent findings challenge the common speculation that the loss of gluten tolerance resulting in the disease usually develops in childhood.
"You're not necessarily born with celiac disease," says Carlo Catassi, M.D., of the Universita Politecnica delle Marche in Italy. Dr. Catassi is the lead author of the paper and co-director of the Center for Celiac Research. "Our findings show that some people develop celiac disease quite late in life."
The trend is supported by clinical data from the center, notes Dr. Catassi, who urges physicians to consider screening their elderly patients.
Although researchers have identified specific genetic markers for the development of celiac disease, exactly how and why an individual loses tolerance to gluten remains a mystery.
"Even if you have these genetic markers, it's not your destiny to develop an autoimmune disease," adds Dr. Fasano. "Our study shows that environmental factors cause an individual's immune system to lose tolerance to gluten, given the fact that genetics was not a factor in our study since we followed the same individuals over time."
The finding contradicts the common wisdom that nothing can be done to prevent autoimmune disease unless the triggers that cause autoimmunity are identified and removed. Gluten is one of the triggers for celiac disease. But if individuals can tolerate gluten for many decades before developing celiac disease, some environmental factor or factors other than gluten must be in play, notes Dr. Fasano.
Identifying and manipulating those factors could lead to novel treatment and possible prevention of celiac disease and other autoimmune disorders including type 1 diabetes, rheumatoid arthritis and multiple sclerosis. Researchers at the University of Maryland Center for Celiac Research are working toward that goal, says Dr. Fasano. As the third most common disease category after cancer and heart disease, autoimmune disorders affect approximately five to eight percent of the U.S. population, according to the National Institutes of Health.
"The groundbreaking research of Dr. Fasano and his team sheds new light on the development of celiac disease, a complex disorder that continues to present challenges to physicians and their patients," says E. Albert Reece, M.D., Ph.D., M.B.A, vice president for medical affairs, University of Maryland, and John Z. and Akiko K. Bowers Distinguished Professor and dean, University of Maryland School of Medicine.
Diagnosis of celiac disease can be a challenge as patients who test positive for the disease may not display the classic symptoms of gastrointestinal distress linked to the disease. Atypical symptoms include joint pain, chronic fatigue and depression. In the study, only 11 percent of people identified as positive for celiac disease autoimmunity through blood samples had actually been diagnosed with the disease.
The University of Maryland Center for Celiac Research engages in clinical care, diagnostic support, education, and clinical and basic science research in celiac disease. Founded in 1995, the center is an international leader in promoting the awareness of celiac disease to provide better care, better quality of life, and more adequate support for the celiac disease community worldwide.
View "Natural History of Celiac Disease Autoimmunity in a USA Cohort Followed Since 1974" in Annals of Medicine.
Insights, Analysis, and Developments
Editorial Note: The idea that celiac disease is strictly a childhood condition has persisted in clinical practice for years, and this study puts hard numbers behind what many gastroenterologists have suspected - that the disease can and does develop at any age, including well into old age. For elderly patients who develop unexplained joint pain, chronic fatigue, or depression, celiac disease may not be on their physician's radar, which is exactly the problem when the study found that only 11 percent of those who tested positive had actually been diagnosed. The broader implications extend well beyond celiac disease itself, because if researchers can identify the environmental factors that cause a person to lose gluten tolerance after tolerating it for decades, those same insights could open doors to preventing other autoimmune disorders that collectively rank as the third most common disease category in the United States after cancer and heart disease - Disabled World (DW).Attribution/Source(s): This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by University of Maryland Medical Center and published on 2010/09/27, this content may have been edited for style, clarity, or brevity.