IBD in the elderly population: Results from a population-based study in Western Hungary, 1977-2008

Peter Laszlo Lakatos, Gyula David, Tunde Pandur, Zsuzsanna Erdelyi, Gabor Mester, Mihaly Balogh, Istvan Szipocs, Csaba Molnar, Erzsebet Komaromi, Lajos S. Kiss, Laszlo Lakatos

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Abstract

Background and aims: Limited data are available on the incidence and disease course of IBD in the elderly population. Our aim was to analyze the incidence and disease course of IBD according to the age at diagnosis in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008. Methods: Data of 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 SD15.9. years; CD: 506, age at diagnosis: 31.5 SD13.8. years). Both hospital and outpatient records were collected and comprehensively reviewed. Results: 106 (11.6%) of UC patients and 21 (4.2%) of CD patients were diagnosed with >60years of age. In UC, the incidence increased from 1.09 to 10.8/105 in the elderly, while CD increased to 3.04/105 in 2002-2007. In CD, colonic location (elderly: 61.9% vs. pediatric: 24.3%, p=0.001, and adults: 36.8%, p=0.02) and stenosing disease (elderly: 42.9% vs. pediatric: 14.9%, p=0.005, and adults: 19.5%, p=0.01) were more frequent in the elderly. A change in disease behavior was absent in the elderly, while in pediatric and adult CD population it was 20.3% (p=0.037), 19.8% (p=0.036) after 5years. In UC, extensive disease was more frequent in pediatric patients compared to the elderly (p=0.003, OR: 2.73, 95%CI: 1.38-5.41). In addition, pediatric (57.3%, p<0.001, OR: 6.58; 95%CI: 3.22-12.9) and adult (39.8%, p<0.001, OR: 3.24; 95%CI: 1.91-5.49) patients required more often systemic steroids during follow-up compared to the elderly (17%). Proximal extension at 10years was 11.6%, but time to extension was not different according to the age at onset. Conclusions: Elderly patients represent an increasing proportion of the IBD population. Stenosing and colon-only disease were characteristic for elderly CD patients, while the disease course in UC was milder.

Original languageEnglish
Pages (from-to)5-13
Number of pages9
JournalJournal of Crohn's and Colitis
Volume5
Issue number1
DOIs
Publication statusPublished - Feb 1 2011

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Keywords

  • Age at diagnosis
  • CD
  • Disease course
  • Elderly
  • Incidence
  • UC

ASJC Scopus subject areas

  • Gastroenterology

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