Lactose intolerance in the older adult

Abstract

A high prevalence of lactose malabsorption has been suggested in the elderly. Mechanisms responsible for this have remained speculative until recently. Recent data suggest that the increased prevalence of lactose malabsorption in the elderly may be due to clinically inapparent small intestinal bacterial overgrowth, rather than any subtle, age-related mucosal factors, at least in populations in which lactose persistence is common in adults. Only a minority of elderly subjects with lactose malabsorption describe symptoms of lactose intolerance. The primary focus in this subgroup should be to assess for, and eradicate if present, the bacterial overgrowth, thereby probably reversing the cause of the lactose malabsorption, and to otherwise ensure that the dietary avoidance of lactose-containing foods does not lead to inadequate nutritional intake, especially calcium intake.