Inflammatory Bowel Disease is Similar in Patients with Older Onset and Younger Onset

Bharati Kochar, Millie D. Long, Joseph Galanko, Laura E. H. Raffals, Ashwin Ananthakrishnan, Robert S. Sandler

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: As the American population is aging, the number of older people with inflammatory bowel disease is increasing. We used clinical data from the Sinai-Helmsley Alliance for Research Excellence (SHARE), a prospective cohort, to examine disease and treatment differences in older adults. Methods: We performed a cross-sectional study assessing demographics and disease behavior by age at diagnosis with univariate, bivariate, and multivariate analyses. "Older-onset" patients were diagnosed after age 60, "younger-onset" patients were diagnosed before age 60 but are older than 60 years, and the remainder were "young." Results: There were 91 older-onset, 389 younger-onset, and 3431 young patients with Crohn's disease. Older-onset patients had more ileal (37%) and colonic (27%) disease compared with younger-onset and young patients. There were no differences in disease behavior, location, or surgeries between older-onset and young patients with Crohn's disease within 5 years of diagnosis. Older-onset patients with inflammatory disease had a higher odds of being in remission. Young patients reported more anti-tumor necrosis factor and thiopurine use compared with younger-onset and older-onset patients (P < 0.01). There were 98 older-onset, 218 younger-onset, and 1702 young patients with ulcerative colitis. There were no differences in disease extent, activity index, or surgeries. Young patients with ulcerative colitis reported more anti-tumor necrosis factor use (26%) compared with younger-onset patients (17%, P < 0.01). Conclusions: Disease behavior or location was not different between younger and older adults with inflammatory bowel disease. Older patients were less likely to be treated with immunosuppression. If older patients have similar disease behavior, less frequent treatment with immunosuppressives may risk suboptimally controlled disease.

Original languageEnglish (US)
Pages (from-to)1187-1194
Number of pages8
JournalInflammatory Bowel Diseases
Volume23
Issue number7
DOIs
StatePublished - Jul 1 2017

Fingerprint

Inflammatory Bowel Diseases
Ulcerative Colitis
Crohn Disease
Tumor Necrosis Factor-alpha
Colonic Diseases
Immunosuppressive Agents
Immunosuppression
Young Adult
Multivariate Analysis
Cross-Sectional Studies
Demography

Keywords

  • aging
  • Crohn's disease
  • elderly
  • geriatric
  • inflammatory bowel disease
  • ulcerative colitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

Cite this

Inflammatory Bowel Disease is Similar in Patients with Older Onset and Younger Onset. / Kochar, Bharati; Long, Millie D.; Galanko, Joseph; Raffals, Laura E. H.; Ananthakrishnan, Ashwin; Sandler, Robert S.

In: Inflammatory Bowel Diseases, Vol. 23, No. 7, 01.07.2017, p. 1187-1194.

Research output: Contribution to journalArticle

Kochar, Bharati ; Long, Millie D. ; Galanko, Joseph ; Raffals, Laura E. H. ; Ananthakrishnan, Ashwin ; Sandler, Robert S. / Inflammatory Bowel Disease is Similar in Patients with Older Onset and Younger Onset. In: Inflammatory Bowel Diseases. 2017 ; Vol. 23, No. 7. pp. 1187-1194.
@article{f3939871c7ef49059f654224a28bce4a,
title = "Inflammatory Bowel Disease is Similar in Patients with Older Onset and Younger Onset",
abstract = "Background: As the American population is aging, the number of older people with inflammatory bowel disease is increasing. We used clinical data from the Sinai-Helmsley Alliance for Research Excellence (SHARE), a prospective cohort, to examine disease and treatment differences in older adults. Methods: We performed a cross-sectional study assessing demographics and disease behavior by age at diagnosis with univariate, bivariate, and multivariate analyses. {"}Older-onset{"} patients were diagnosed after age 60, {"}younger-onset{"} patients were diagnosed before age 60 but are older than 60 years, and the remainder were {"}young.{"} Results: There were 91 older-onset, 389 younger-onset, and 3431 young patients with Crohn's disease. Older-onset patients had more ileal (37{\%}) and colonic (27{\%}) disease compared with younger-onset and young patients. There were no differences in disease behavior, location, or surgeries between older-onset and young patients with Crohn's disease within 5 years of diagnosis. Older-onset patients with inflammatory disease had a higher odds of being in remission. Young patients reported more anti-tumor necrosis factor and thiopurine use compared with younger-onset and older-onset patients (P < 0.01). There were 98 older-onset, 218 younger-onset, and 1702 young patients with ulcerative colitis. There were no differences in disease extent, activity index, or surgeries. Young patients with ulcerative colitis reported more anti-tumor necrosis factor use (26{\%}) compared with younger-onset patients (17{\%}, P < 0.01). Conclusions: Disease behavior or location was not different between younger and older adults with inflammatory bowel disease. Older patients were less likely to be treated with immunosuppression. If older patients have similar disease behavior, less frequent treatment with immunosuppressives may risk suboptimally controlled disease.",
keywords = "aging, Crohn's disease, elderly, geriatric, inflammatory bowel disease, ulcerative colitis",
author = "Bharati Kochar and Long, {Millie D.} and Joseph Galanko and Raffals, {Laura E. H.} and Ashwin Ananthakrishnan and Sandler, {Robert S.}",
year = "2017",
month = "7",
day = "1",
doi = "10.1097/MIB.0000000000001115",
language = "English (US)",
volume = "23",
pages = "1187--1194",
journal = "Inflammatory Bowel Diseases",
issn = "1078-0998",
publisher = "John Wiley and Sons Inc.",
number = "7",

}

TY - JOUR

T1 - Inflammatory Bowel Disease is Similar in Patients with Older Onset and Younger Onset

AU - Kochar, Bharati

AU - Long, Millie D.

AU - Galanko, Joseph

AU - Raffals, Laura E. H.

AU - Ananthakrishnan, Ashwin

AU - Sandler, Robert S.

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Background: As the American population is aging, the number of older people with inflammatory bowel disease is increasing. We used clinical data from the Sinai-Helmsley Alliance for Research Excellence (SHARE), a prospective cohort, to examine disease and treatment differences in older adults. Methods: We performed a cross-sectional study assessing demographics and disease behavior by age at diagnosis with univariate, bivariate, and multivariate analyses. "Older-onset" patients were diagnosed after age 60, "younger-onset" patients were diagnosed before age 60 but are older than 60 years, and the remainder were "young." Results: There were 91 older-onset, 389 younger-onset, and 3431 young patients with Crohn's disease. Older-onset patients had more ileal (37%) and colonic (27%) disease compared with younger-onset and young patients. There were no differences in disease behavior, location, or surgeries between older-onset and young patients with Crohn's disease within 5 years of diagnosis. Older-onset patients with inflammatory disease had a higher odds of being in remission. Young patients reported more anti-tumor necrosis factor and thiopurine use compared with younger-onset and older-onset patients (P < 0.01). There were 98 older-onset, 218 younger-onset, and 1702 young patients with ulcerative colitis. There were no differences in disease extent, activity index, or surgeries. Young patients with ulcerative colitis reported more anti-tumor necrosis factor use (26%) compared with younger-onset patients (17%, P < 0.01). Conclusions: Disease behavior or location was not different between younger and older adults with inflammatory bowel disease. Older patients were less likely to be treated with immunosuppression. If older patients have similar disease behavior, less frequent treatment with immunosuppressives may risk suboptimally controlled disease.

AB - Background: As the American population is aging, the number of older people with inflammatory bowel disease is increasing. We used clinical data from the Sinai-Helmsley Alliance for Research Excellence (SHARE), a prospective cohort, to examine disease and treatment differences in older adults. Methods: We performed a cross-sectional study assessing demographics and disease behavior by age at diagnosis with univariate, bivariate, and multivariate analyses. "Older-onset" patients were diagnosed after age 60, "younger-onset" patients were diagnosed before age 60 but are older than 60 years, and the remainder were "young." Results: There were 91 older-onset, 389 younger-onset, and 3431 young patients with Crohn's disease. Older-onset patients had more ileal (37%) and colonic (27%) disease compared with younger-onset and young patients. There were no differences in disease behavior, location, or surgeries between older-onset and young patients with Crohn's disease within 5 years of diagnosis. Older-onset patients with inflammatory disease had a higher odds of being in remission. Young patients reported more anti-tumor necrosis factor and thiopurine use compared with younger-onset and older-onset patients (P < 0.01). There were 98 older-onset, 218 younger-onset, and 1702 young patients with ulcerative colitis. There were no differences in disease extent, activity index, or surgeries. Young patients with ulcerative colitis reported more anti-tumor necrosis factor use (26%) compared with younger-onset patients (17%, P < 0.01). Conclusions: Disease behavior or location was not different between younger and older adults with inflammatory bowel disease. Older patients were less likely to be treated with immunosuppression. If older patients have similar disease behavior, less frequent treatment with immunosuppressives may risk suboptimally controlled disease.

KW - aging

KW - Crohn's disease

KW - elderly

KW - geriatric

KW - inflammatory bowel disease

KW - ulcerative colitis

UR - http://www.scopus.com/inward/record.url?scp=85021296522&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021296522&partnerID=8YFLogxK

U2 - 10.1097/MIB.0000000000001115

DO - 10.1097/MIB.0000000000001115

M3 - Article

C2 - 28410340

AN - SCOPUS:85021296522

VL - 23

SP - 1187

EP - 1194

JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

SN - 1078-0998

IS - 7

ER -