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Gastric acidity in older adults
A Hurwitz1, D A Brady, S E Schaal
1Department of Medicine, University of Kansas Medical Center, Kansas City 66160-7320, USA. ahurwitz@kumc.edu
JAMA
|August 27, 1997
Summary
Most older adults maintain gastric acidity, challenging previous beliefs. Low acidity in some elderly individuals is linked to atrophic gastritis, indicating a need for further research.
Area of Science:
- Gastroenterology
- Geriatrics
- Internal Medicine
Background:
- Conventional wisdom suggested declining gastric acidity with age.
- However, the rarity of achlorhydria sequelae in the elderly questioned this notion.
Purpose of the Study:
- To determine the prevalence of basal gastric acidity in older adults.
- To assess the prevalence of atrophic gastritis using serum pepsinogen ratios in this demographic.
Main Methods:
- A cross-sectional study involving 248 independent, elderly volunteers (aged 65+).
- Noninvasive evaluation of basal gastric acid secretion using quininium resin.
- Atrophic gastritis diagnosis based on serum pepsinogen I/II ratio (<2.9).
Main Results:
- 84% of subjects exhibited acidic gastric content (pH <3.5) in the basal state.
- Prevalence estimates: 67% consistent acid secretion, 22% intermittent, 11% consistently high pH.
- Consistent hyposecretors (low acid) showed a high prevalence of atrophic gastritis (67%) compared to acid secretors (5%).
Conclusions:
- Contrary to common belief, most elderly individuals retain gastric acid secretion capacity.
- Low gastric acidity in the elderly is significantly associated with atrophic gastritis.
- Findings suggest a re-evaluation of age-related gastric acidity decline is warranted.
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