Abstract
BackgroundDespite the substantial number of older adults suffering from gastrointestinal (GI) symptoms little is known regarding the character of these complaints and whether they are associated with an altered intestinal barrier function and psychological distress. Our aim was to explore the relationship between self-reported gut health, intestinal permeability and psychological distress among older adults.MethodsThree study populations were included: 1) older adults with GI symptoms (n = 24), 2) a group of older adults representing the general elderly population in Sweden (n = 22) and 3) senior orienteering athletes as a potential model of healthy ageing (n = 27). Questionnaire data on gut-health, psychological distress and level of physical activity were collected. Intestinal permeability was measured by quantifying zonulin in plasma. The level of systemic and local inflammation was monitored by measuring C-reactive protein (CRP), hydrogen peroxide in plasma and calprotectin in stool samples. The relationship between biomarkers and questionnaire data in the different study populations was illustrated using a Principal Component Analysis (PCA).ResultsOlder adults with GI symptoms displayed significantly higher levels of both zonulin and psychological distress than both general older adults and senior orienteering athletes. The PCA analysis revealed a separation between senior orienteering athletes and older adults with GI symptoms and showed an association between GI symptoms, psychological distress and zonulin.ConclusionsOlder adults with GI symptoms express increased plasma levels of zonulin, which might reflect an augmented intestinal permeability. In addition, this group suffer from higher psychological distress compared to general older adults and senior orienteering athletes. This relationship was further confirmed by a PCA plot, which illustrated an association between GI symptoms, psychological distress and intestinal permeability.
Highlights
Despite the substantial number of older adults suffering from gastrointestinal (GI) symptoms little is known regarding the character of these complaints and whether they are associated with an altered intestinal barrier function and psychological distress
Intestinal permeability Assessment of zonulin, an indirect marker of intestinal permeability, showed significantly increased levels among older adults suffering from GI symptoms, compared to general older adults (p < 0.05) but not to senior orienteering athletes (Fig. 1)
The level of probable depression was found to be significantly higher among older adults with GI symptoms compared to both general older adults (p < 0.01) and senior orienteering athletes (p < 0.001) (Fig. 2a)
Summary
Despite the substantial number of older adults suffering from gastrointestinal (GI) symptoms little is known regarding the character of these complaints and whether they are associated with an altered intestinal barrier function and psychological distress. Our aim was to explore the relationship between self-reported gut health, intestinal permeability and psychological distress among older adults. It is important to identify areas through which a healthy ageing process can be promoted in order to increase the proportion of independent free-living older adults [2]. Increased intestinal permeability is a hallmark of many GI diseases [12,13,14] but has not been investigated in older adults who self-report GI symptoms. We aim to investigate how self-reported GI symptoms among older adults correlate to plasma zonulin (an indicator of increased intestinal permeability) [21, 22] and psychological distress
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