Skip to main content
×
×
Home

Ageing and the gut

  • Edward Britton (a1) and John T. McLaughlin (a1) (a2)
Abstract

The goal of this brief review is to address the role of the ageing gut in the genesis of malnutrition in the elderly. We assess the burden of malnutrition in the elderly, exploring the role of comorbid conditions and neurohumoral changes that take place to contribute towards the process of anorexia associated with ageing. Following this, the review assesses physiological changes that occur in each part of the gastrointestinal (GI) tract and what implication they may have in clinical practice. In the oropharynx and the oesophagus, changes in swallowing and oesophageal motility associated with ageing can be demonstrated using physiological testing. However, in the absence of comorbid disease, they often have little, if any, clinical significance. In the stomach, reduced fundal compliance may contribute to early satiety; however, the primary change is hypochlorhydria, which may predispose to malabsorption or bacterial overgrowth further along the GI tract. Almost uniquely, the small bowel, particularly its absorptive function, is unaffected by age and we review the literature demonstrating this. In the colon, there is evidence of a prolonged transit time related to a reduction in both neurotransmitters and receptors. Although this may cause symptoms, this aspect is unlikely to contribute to malnutrition. In addition, we assess the potential changes in the gut microbiome and how this may interact with the immune system in the process of ‘inflamm-ageing’. We conclude by summarising the main changes and their impact for the clinician along with recommendations for future areas of research.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Ageing and the gut
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Ageing and the gut
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Ageing and the gut
      Available formats
      ×
Copyright
Corresponding author
* Corresponding author: Professor J. McLaughlin, fax +44 161 206 1495, email John.Mclaughlin@manchester.ac.uk
References
Hide All
1. BAPEN: Malnutrition among 234 Older People in the Community: Policy Recommendations for Change; 17 May 2006. Redditch: BAPEN.
2. Roberts, SB, Fuss, P, Heyman, MB et al. (1995) Control of food intake in older men. JAMA 273, 702.
3. Morley, JE (2007) The aging gut: physiology. Clin Geriatr Med 23, 757767.
4. Boyce, JM & Shone, GR (2006) Effects of ageing on smell and taste. Postgrad Med J 82, 239241.
5. Fukunaga, A, Uematsu, H & Sugimoto, K (2005) Influences of aging on taste perception and oral somatic sensation. J Gerontol A Biol Sci Med Sci 60, 109113.
6. Rolls, BJ (1999) Do chemosensory changes influence food intake in the elderly? Physiol Behav 66, 193197.
7. Sturm, K, Parker, B, Wishart, J et al. (2004) Energy intake and appetite are related to antral area in healthy young and older subjects. Am J Clin Nutr 80, 656667.
8. Di Francesco, V, Zamboni, M, Dioli, A et al. (2005) Delayed postprandial gastric emptying and impaired gallbladder contraction together with elevated cholecystokinin and peptide YY serum levels sustain satiety and inhibit hunger in healthy elderly persons. J Gerontol A Biol Sci Med Sci 60, 15811585.
9. Di Francesco, V, Fantin, F, Omizzolo, F, Residori, L, Bissoli, L, Bosello, O, Zamboni, M. (2007) The anorexia of aging. Dig Dis 25, 129137.
10. Gaskin, FS, Farr, SA, Banks, WA et al. (2003) Ghrelin-induced feeding is dependent on nitric oxide. Peptides 24, 913918.
11. Morley, JE, Alshaher, MM, Farr, SA et al. (1999) Leptin and neuropeptide Y (NPY) modulate nitric oxide synthase: further evidence for a role of nitric oxide in feeding. Peptides 20, 595600.
12. MacIntosh, CG, Andrews, JM, Jones, KL et al. (1999) Effects of age on concentrations of plasma cholecystokinin, glucagon-like peptide 1, and peptide YY and their relation to appetite and pyloric motility. Am J Clin Nutr 69, 9991006
13. Soergel, KH, Zborlaske, FF, Amberg, JR (1964) Presbyesophagus: esophageal motility in nonagenarians. J Clin Invest 45, 14721479.
14. Shaker, R, Ren, J, Podvrsan, B et al. (1993) Effect of aging and bolus variables on pharyngeal and upper esophageal sphincter motor function. Am J Physiol 262, G427G432.
15. Grande, L, Lacima, G, Ros, E et al. (1999) Deterioration of esophageal motility with age: a manometric study of 79 healthy subjects. Am J Gastroenterol 94, 17951801.
16. Ren, J, Shaker, R, Zamir, Z et al. (1993) Effect of age and bolus variables on the coordination of the glottis and upper esophageal sphincter during swallowing. Am J Gastroenterol 88, 665669.
17. Adamek, RJ, Wegener, M, Wienbeck, M et al. (1994) Long-term esophageal manometry in healthy subjects. Evaluation of normal values and influence of age. Dig Dis Sci 39, 20692073.
18. Corazza, GR, Frazzoni, M, Gatto, MR et al. (1986) Ageing and small-bowel mucosa: a morphometric study. Gerontology 32, 6065.
19. Holt, PR, Pascal, RR & Kotler, DP (1984) Effect of aging upon small intestinal structure in the Fischer rat. J Gerontol 39, 642647.
20. Lipski, PS, Bennett, MK, Kelly, PJ et al. (1992) Ageing and duodenal morphometry. J Clin Pathol 45, 450452.
21. Beaumont, DM, Cobden, I, Sheldon, WL et al. (1987) Passive and active carbohydrate absorption by the ageing gut. Age Ageing 16, 294300.
22. Saweirs, WM, Andrews, DJ & Low-Beer, TS (1985) The double sugar test of intestinal permeability in the elderly. Age Ageing 14, 312315.
23. Saltzman, JR, Kowdley, KV, Perrone, G et al. (1995) Changes in small intestine permeability with aging. J Am Geriatr Soc 43, 160164.
24. Arora, S, Kassarjian, Z, Krasinski, SD et al. (1989) Effect of age on tests of intestinal and hepatic function in healthy humans. Gastroenterology 96, 15601565.
25. Meier, J & Sturm, A (2009) The intestinal epithelial barrier: does it become impaired 298 with age? Dig Dis 27, 240245.
26. Holt, PR (2007) Intestinal malabsorption in the elderly. Dig Dis 25, 144150.
27. O'Mahony, D, O'Leary, P & Quigley, EMM (2002) Aging and intestinal motility: a review of factors that affect intestinal motility in the aged. Drugs Aging 19, 515527.
28. Salles, N (2007) Basic mechanisms of the aging gastrointestinal tract. Dig Dis 25, 112117.
29. Gomes, OA, de Souza, RR & Liberti, EA (1997) A preliminary investigation of the effects of aging on the nerve cell number in the myenteric ganglia of the human colon. Gerontology 43, 210217.
30. Takahashi, T, Qoubaitary, A, Owyang, C et al. (2000) Decreased expression of nitric oxide synthase in the colonic myenteric plexus of aged rats. Brain Res 883, 1521.
31. Roberts, D, Gelperin, D & Wiley, JW (1994) Evidence for age-associated reduction in acetylcholine release and smooth muscle response in the rat colon. Am J Physiol 267, G515G552.
32. Asuzu, DT, Hayashi, Y, Izbeki, F et al. (2011) Generalized neuromuscular hypoplasia, reduced smooth muscle myosin and altered gut motility in the klotho model of premature aging. Neurogastroenterol Motil 23, e309e323.
33. Korecka, A & Arulampalam, V (2012) The gut microbiome: scourge, sentinel or spectator? J Oral Microbiol 4, 9367.
34. Biagi, E, Nylund, L, Candela, M et al. Through ageing, and beyond: gut microbiota and inflammatory status in seniors and centenarians. PLoS One 5, e10667.
35. Ishimoto, Y, Tomiyama-Miyaji, C, Watanabe, H et al. (2004) Age-dependent variation in the proportion and number of intestinal lymphocyte subsets, especially natural killer T cells, double-positive CD4+ CD8+ cells and B220+ T cells, in mice. Immunology 113, 371377.
36. Mariani, E, Pulsatelli, L, Meneghetti, A et al. (2001) Different IL-8 production by T and NK lymphocytes in elderly subjects. Mech Ageing Dev 122, 13831395.
37. Plackett, TP, Boehmer, ED, Faunce, DE et al. (2004) Aging and innate immune cells. J Leukoc Biol 76, 291299.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Proceedings of the Nutrition Society
  • ISSN: 0029-6651
  • EISSN: 1475-2719
  • URL: /core/journals/proceedings-of-the-nutrition-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score