European Crohn’s and Colitis Organisation Topical Review on IBD in the Elderly: Table 1.

Abstract

This ECCO topical review of the European Crohn's and Colitis Organisation [ECCO] focuses on the epidemiology, pathophysiology, diagnosis, management and outcome of the two most common forms of inflammatory bowel disease, Crohn's disease and ulcerative colitis, in elderly patients. The objective was to reach expert consensus to provide evidence-based guidance for clinical practice.

The Management of Inflammatory Bowel Disease in Elderly: Current Evidence and Future Perspectives

“…Previously published reviews on IBD in the elderly have set a threshold value of 60 years of age [3,4,6,7], whereas the age of 65 years has been fixed as a reference value for the definition of elderly in other reports [1,8,9].…”

“…Despite some variability of data across epidemiological studies due to regional differences and methods of diagnosis, the incidence rates of ulcerative colitis (UC) in the elderly are higher than those for Crohn's disease (CD) and range from 1 to 20/100,000 for UC in Europe and in the United States [6] compared to 1 to 10/100,000 for CD in Europe [1,6]. A recently published National cohort study in Sweden has reported that 23% of subjects with diagnosed IBD had a first diagnosis of IBD at age ≥60 years and that in elderly patients, the IBD incident rate was 35/100,000 person/years (male: 37; female: 33) and was 10/100,000 for CD, 19/100,000 for UC, and 5/100,000 for IBD unclassified [11].…”

Editorial: thiopurine‐induced myelosuppression and infections in inflammatory bowel disease patients with a normal TPMT genotype—the perils of ageing. Authors’ reply

“…3 Data which have identified clusters of infected individuals 5,6 with similar DNA signatures 7 is consistent with spread of infection between cluster members and/or an environmental exposure which is common to the cluster. If that is the case, our current "case finding" approach to H. pylori infection is unlikely to lead to a decrease in recurrence rates.…”

“…In the systematic review and meta-analysis by Hu et al, 3 the authors identified an overall mean annual recurrence rate of 4.3%…”

“…The proportion of elderly patients within the IBD population is increasing, including a group of patients with late onset disease. 3 Although in the latter, the disease course is mostly mild, a significant number of patients with such late onset UC and CD may also display an aggressive disease course. 4 Evidence-based treatment strategies are scarce, because these patients have typically been excluded from efficacy studies.…”