A new and comprehensive study, led by Columbia University Mailman School of Public Health’s Benjamin Lebwohl, MD, MS, assistant professor of Medicine and Epidemiology, and investigators at Columbia’s Celiac Disease Center, has found that celiac patients are at no increased risk for dementia before or after their diagnosis of celiac disease.
“Celiac disease did not increase the risk of Alzheimer’s in this population-based study,” said Dr. Lebwohl. “We did not find evidence of increased dementia risk prior to the diagnosis of celiac disease, either.”
“Patients coming to our center have long described ‘brain fog,’ and it appears that gluten can cause cognitive effects in some individuals with and without celiac disease,” said Peter Green, MD, the Phyllis and Ivan Seidenberg Professor of Medicine at Columbia University and the director of the Celiac Disease Center. “However, we didn’t know if these effects have long-term consequences in the form of increased risk of dementia.”
The paper, titled “Risk of Dementia in Patients with Celiac Disease: A Population-Based Cohort Study” and published in the Journal of Alzheimer’s Disease. was a collaborative effort with Jonas Ludvigsson, MD, PhD, at the Karolinska Institute in Stockholm, Sweden. It analyzed data on 8,846 individuals over the age of 50, matching patients with celiac disease to controls with regard to their rate of developing dementia. After a median follow-up period of 8.4 years, dementia was diagnosed in 4.3% of celiac disease patients and 4.4% of matched controls.
While celiac disease had no effect on the risk of Alzheimer’s dementia, the investigators did find a small increase in the risk of vascular dementia. “We know that patients with celiac disease have a modestly increased rate of cardiovascular disease, and that patients who experience neurologic symptoms have abnormalities on MRIs that mimic vascular disease,” said Dr. Lebwohl. But, he added, “Our findings on vascular dementia were small and may be due to chance.”
Given public interest in the effects of gluten on mental function, this study offers a response to the claims offered in some popular books, which state that wheat or gluten (or grains in general) have toxic effects on the brain and may be responsible for a rise in Alzheimer’s dementia. Part of the rationale for these claims came from the observation that patients with celiac disease frequently report cognitive symptoms when they are exposed to gluten.
“People who promote an anti-grain or anti-gluten agenda sometimes cite our work in celiac disease, drawing far-ranging conclusions that extend well beyond evidence-based medicine,” said Dr. Green. “We know ‘brain fog’ is a serious symptom commonly reported by our patients, and it’s understandable that people have been worried about a possible connection to dementia. Fortunately, our work with Dr. Ludvigsson provides concrete evidence that this particular worry can be laid to rest.”
The study was funded by grants from the National Center for Advancing Translational Sciences, National Institutes of Health (UL1 TR000040); JFL: Örebro University Hospital, Karolinska Institutet, the Swedish Society of Medicine, the Swedish Research Council –Medicine (522-2A09-195) and the Swedish Celiac Society.