Ulcerative colitis in the elderly: clinical patterns and outcome in 51 Greek patients

Triantafillidis, John K.; Emmanouilidis, Anastasios; Pomonis, E; Cheracakis, Petros; Hereti, Irini; Merikas, Emmanuel; Nicolakis, D; Argyros, Nikolaos

doi:10.1007/s005350170096

Cited by 30 publications

(28 citation statements)

References 13 publications

(10 reference statements)

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“…In contrast to our findings, a retrospective study from Greece by Triantafillidis et al [17] found no difference in UC disease extent by age of diagnosis. Fifty-one (12%) patients were diagnosed after age 60, while 362 were diagnosed prior to age 60.…”

Section: Discussioncontrasting

confidence: 99%

Association of Age at Diagnosis and Ulcerative Colitis Phenotype

Quezada

Cross

2012

Dig Dis Sci

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Background Ulcerative colitis (UC) primarily affects young adults; however, 12% of patients are diagnosed at an advanced age. Previous studies report that older patients are less likely to have pancolitis and more likely to have distal disease location. Aims Our objective was to compare UC phenotype by age of diagnosis in a tertiary referral cohort. Methods Retrospective database analysis. Demographics, disease extent, and EIM were compared by the following age of diagnosis groups:<17 years, 17–40 years, and>40 years. Results A total of 260 patients evaluated between July 1, 2004 and April 19, 2010 were included. Race, smoking history, extraintestinal manifestations of disease, and disease duration were significantly associated with age of diagnosis. As age of diagnosis increased, the proportion of non-white patients increased (p = 0.04), former smoking history increased (p<0.001), extraintestinal manifestations of disease decreased (p<0.017), and disease duration decreased (p<0.0001). As age of diagnosis increased, there was a trend for a higher proportion of patients with proctitis and a decreased proportion of patients with pancolitis. Multivariable analysis adjusting for sex, race, smoking history, family history, and disease duration demonstrated that diagnosis at >40 years was associated with a decreased likelihood for pancolitis compared to younger cohorts (OR 0.43, 95% CI 0.24, 0.76). Conclusions Diagnosis of ulcerative colitis after age 40 years was associated with decreased disease extent compared to younger age groups, even after adjustment for sex, race, smoking history, family history, and disease duration. Our results suggest that older patients have distinct clinical phenotypes.

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Section: Discussioncontrasting

confidence: 99%

Association of Age at Diagnosis and Ulcerative Colitis Phenotype

Quezada

Cross

2012

Dig Dis Sci

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“…In addition, among the elderly a notably lower severity index was found, suggesting a decline in severity in this population as interpreted from the decrease in number of exacerbations, regression in extension of the inflammatory lesions, colectomy requirements, and risk of colorectal cancer as previously reported. [38][39][40] This evidence could be helpful for future classification of UC, indicating that a more meaningful age division may be set at 60 years, stratifying patients above this age as elderly colitis. This observation was previously found in the IBSEN study, 28 suggesting that the course of UC becomes milder with increasing age, and that the initial age should be detached from the clinical classification of patients.…”

Section: Discussionmentioning

confidence: 96%

Ulcerative colitis in northern Portugal and Galicia in Spain

Acosta

Magro

Carpio

et al. 2010

Inflammatory Bowel Diseases

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“…[25][26][27] Data on the disease course of EO IBD are mainly derived from small selected referral center cohorts, some collected decades ago. [28][29][30][31][32][33][34][35][36][37][38][39] Recent population-based data from the Hungarian registry and the French EPIMAD registry suggested a somewhat milder course of IBD diagnosed at older age, yet the number of elderly patients was limited 40 or data from the corresponding adult population were lacking, 41 impeding a direct comparison. To balance benefit and risk of treatment strategies in the elderly population, information on the current treatment strategy and disease outcome is needed, preferably from a large unselected population of patients with IBD studied in direct comparison to AO disease.…”

mentioning

confidence: 99%