The intestinal epithelial barrier: does it become impaired with age?

The proportion of the population aged over 65 is increasing rapidly and malnutrition is a more common problem in elderly patients. The intestinal epithelium covers the surface of the digestive tract and consists of epithelial cells that constitute an efficient physical barrier between the dietary and enteric flora pathogens found in the intestinal lumen and the individuum, while at the same time allowing an exchange between nutrients and the systemic circulation. There is only a very limited amount of information available on whether and how age, with concomitant inflammation, influences the epithelial barrier. Although there is evidence that age does not correlate with the area of the duodenal surface epithelium or the number of intraepithelial lymphocytes, absorption of certain nutrients, e.g. lipids, does seem to be impaired in the elderly. However, impaired blood flow, ischemic changes and the increased use of NSAIDs naturally contribute to an impaired epithelial barrier in elderly patients.