Onset during old age has been reported in up to 10% of total cases of inflammatory bowel disease.
Dr Manosa and colleagues from Spain evaluated phenotypic characteristics and the use of therapeutic resources in patients with elderly onset inflammatory bowel disease.
The team performed a case-control study including all those patients diagnosed with inflammatory bowel disease over the age of 60 years since 2000 who were followed-up for >12 months, identified from the inflammatory bowel disease databases.
Elderly onset cases were compared with inflammatory bowel disease patients aged 18 to 40 years at diagnosis, matched by year of diagnosis, gender and type of inflammatory bowel disease.
The research team included 1374 elderly onset and 1374 adult-onset cases.
The doctors found that among ulcerative colitis patients, elderly onset cases had a lower proportion of extensive disease.
Elderly onset cases had a lower proportion of extensive disease
|Alimentary Pharmacology and Therapeutics
In Crohn's disease, elderly onset cases showed an increased rate of stenosing pattern and exclusive colonic location, whereas penetrating pattern was significantly less frequent.
The researchers discovered that with the use of therapeutic resources, there was a significantly lower use of corticosteroids, immunosuppressants and infliximab and/or adalimumab agents in elderly onset cases.
Regarding surgery, the team found a significantly higher surgery rate among elderly onset ulcerative colitis cases.
Finally, elderly onset cases were characterised by a higher rate of hospitalizations and neoplasms.
Dr Manosa's team concludes, "Elderly onset inflammatory bowel disease shows specific characteristics and they are managed differently, with a lower use of immunosuppressants and a higher rate of surgery in ulcerative colitis."