INTRODUCTION Celiac disease (CeD) is increasingly diagnosed in older adults, though few studies have explored complications in this group. As frailty confers increased risk for adverse events, we aimed to explore frailty in older adults with CeD. METHODS In a nationwide Swedish cohort, we identified adults ≥60 years with incident CeD between 2004 and 2017 which we matched to population-based controls without CeD by age, sex, county, and calendar-period. Baseline frailty within 3 years before CeD diagnosis or index date was assessed using the Hospital Frailty Risk Score. Among those without baseline frailty, we used conditional logistic regression to estimate odds ratios and 95% confidence intervals of future frailty at 5 years comparing CeD with controls. Logistic regression was used to evaluate the association between persistent villous atrophy vs mucosal healing and frailty in patients with CeD. RESULTS A total of 4,646 older adults with CeD were matched to 21,944 non-CeD individuals. Baseline frailty was increased in patients with CeD (54.4%) compared with controls (29.7%, P < 0.001), which existed across all frailty categories: low-risk (43.4% vs 23.8%), intermediate-risk (10.3% vs 5.4%), and high-risk (0.8% vs 0.6%). Among those without baseline frailty, patients with CeD had a 61% increased risk of overall frailty at 5 years (95% confidence interval 1.46-1.78). Mucosal healing in CeD individuals on follow-up biopsy did not protect against future frailty. DISCUSSION Older adults with CeD were significantly more likely to become frail than matched comparators. This analysis reveals the increased vulnerability that older patients with CeD are likely to experience.

中文翻译：

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患有乳糜泻的老年人患衰弱的风险增加：一项全国性的队列研究。


引言乳糜泻 （CeD） 越来越多地在老年人中被诊断出来，尽管很少有研究探讨该群体的并发症。由于虚弱会增加不良事件的风险，我们旨在探讨患有 CeD 的老年人的虚弱。方法 在瑞典全国队列中，我们确定了 2004 年至 2017 年间 ≥60 岁发生 CeD 的成年人，我们按年龄、性别、县和日历周期将其与无 CeD 的基于人群的对照相匹配。使用医院衰弱风险评分评估 CeD 诊断或指数日期前 3 年内的基线衰弱。在没有基线衰弱的患者中，我们使用条件 logistic 回归来估计 CeD 与对照组相比 5 年时未来衰弱的比值比和 95% 置信区间。采用 Logistic 回归评估 CeD 患者持续性绒毛萎缩与粘膜愈合和虚弱之间的相关性。结果 共有 4,646 名患有 CeD 的老年人与 21,944 名非 CeD 个体相匹配。与对照组 （29.7%，P < 0.001） 相比，CeD 患者 （54.4%） 的基线衰弱程度增加，这存在于所有衰弱类别中：低风险 （43.4% 对 23.8%）、中风险 （10.3% 对 5.4%） 和高风险 （0.8% 对 0.6%）。在没有基线衰弱的患者中，CeD 患者在 5 年时总体衰弱的风险增加了 61% （95% 置信区间 1.46-1.78）。随访活检的 CeD 个体的粘膜愈合并不能防止未来的虚弱。讨论 患有 CeD 的老年人比匹配的对照组明显更容易变得虚弱。该分析揭示了老年 CeD 患者可能经历的脆弱性增加。