{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:15:11Z","timestamp":1790151311496,"version":"4.0.1"},"reference-count":66,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\/MCTES","award":["10.54499\/UIDB\/04585\/2020"],"award-info":[{"award-number":["10.54499\/UIDB\/04585\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background\/Objectives: Age-related changes in the gastric mucosa remain incompletely understood. We aimed to assess and compare clinical, endoscopic and histologic changes in the gastric mucosa associated with aging, and to explore whether gastric aging is associated with a distinct histological pattern. Methods: Single-center observational study. Younger (18\u201345 years) and older (\u226570 years) adults undergoing elective upper endoscopy were included and underwent gastric biopsies. The clinical, endoscopic and histologic features were analyzed and compared. Results: A total of 100 patients were included (45 men\/55 women), 50 with 18\u201345 years and 50 with \u226570 years. Dyspepsia, gastro-esophageal reflux disease and peptic ulcer disease were the most common indications for upper endoscopy. Gastric lesions (erythema, erosions, ulceration and polyps) were more common in older patients (80% vs. 50%, p = 0.003), as well as histologic changes such as chronic gastritis (56% vs. 38%, p = 0.004), chronic atrophic gastritis (CAG; 28% vs. 4%, p &lt; 0.001) and intestinal metaplasia (28% vs. 4%, p &lt; 0.001). These findings persisted after adjusting for Helicobacter pylori (H. pylori) status and proton pump inhibitor intake on the multivariate analysis. Prevalence of H. pylori was similar between both groups (28% vs. 32%, p = 0.189). Conclusions: Aging is associated with clinical, endoscopic and histologic changes in the gastric mucosa including CAG and metaplasia, independent of the presence of H. pylori. These findings may result from several aging-related pathophysiological processes and decades of cumulative gastric injury and support the hypothesis of an aging stomach phenotype, underscoring the need for an age-adjusted interpretation of gastric biopsies.<\/jats:p>","DOI":"10.3390\/medsci13040224","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T08:22:08Z","timestamp":1759911728000},"page":"224","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical, Endoscopic and Histologic Differences in Gastric Mucosa Between Younger and Older Adults: An Observational Study on the Aging Stomach"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3757-6172","authenticated-orcid":false,"given":"Francisco","family":"Vara-Luiz","sequence":"first","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"},{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Mendes","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"},{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3749-4342","authenticated-orcid":false,"given":"Carolina","family":"Palma","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"},{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6584-1199","authenticated-orcid":false,"given":"Paulo","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Elisa","family":"Teles","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3332-8590","authenticated-orcid":false,"given":"In\u00eas Costa","family":"Santos","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4920-9158","authenticated-orcid":false,"given":"Gon\u00e7alo","family":"Nunes","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"},{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Patita","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2676-3351","authenticated-orcid":false,"given":"Irina","family":"Mocanu","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Pires","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T\u00e2nia","family":"Meira","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Vieira","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Pinto-Marques","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8318-0945","authenticated-orcid":false,"given":"Daniel","family":"Gomes-Pinto","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6477-7028","authenticated-orcid":false,"given":"Jorge","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Hospital Garcia de Orta, 2805-267 Almada, Portugal"},{"name":"Aging Lab, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1093\/gerona\/58.3.M232","article-title":"Morbidity profiles of centenarians: Survivors, delayers, and escapers","volume":"58","author":"Evert","year":"2003","journal-title":"J. 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