Dementia in coeliac disease

Coeliac patients might be at increased risk of cognitive impairment and early onset dementia, according to a US case study.  

Previous research has shown that coeliac disease can trigger neurological problems such as ataxia and peripheral neuropathy, but this is the first study to suggest that it could cause dementia.  

The researchers searched records of patients at the Mayo Clinic in Minnesota between 1970 and 2005 to see if there were any cases of cognitive decline associated with coeliac disease diagnosis.  

They identified 13 patients, including five women, who developed cognitive impairment within two years of symptomatic onset of coeliac disease or following a severe exacerbation of the condition. Of these, five patients developed neurological and GI symptoms simultaneously.  

The patients developed cognitive impairment between the ages of 47 and 79, and the main presenting features were amnesia, acalculia, confusion and personality changes. 

The researchers found that those patients who developed neurological symptoms including ataxia and peripheral neuropathy around the time of onset of coeliac disease had the lowest scores on mental status tests.  

They found that three of the patients improved or stabilised cognitively when they were put on a gluten-free diet.  

Lead researcher Dr Keith Josephs, a neurologist at the Mayo Clinic, said: ‘I did not expect to find so many patients with onset of cognitive impairment and coeliac disease within two years of each other.  

‘Given the temporal link between the symptoms starting and the cognitive decline, this is unlikely to be a chance connection.’  

He said the mechanism behind the association was unclear,  but that coeliac disease could cause dementia through nutritional deficiency or increases in inflammatory cytokine levels in the brain.  

He added this was another reason for coeliac disease patients to ensure they eat only gluten-free foods. 

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