Abstract
Background & AimsWe aimed to perform geriatric assessment in older patients with inflammatory bowel disease (IBD) to evaluate which IBD characteristics associate with deficits in geriatric assessment and the impact of deficits on disease burden (health-related quality of life). MethodsA prospective multicenter cohort study including 405 consecutive outpatient patients with IBD aged ≥65 years. Somatic domain (comorbidity, polypharmacy, malnutrition), impairments in (instrumental) activities of daily living, physical capacity (handgrip strength, gait speed), and mental (depressive symptoms, cognitive impairment) and social domain (life-partner) were assessed. Deficits in geriatric assessment were defined as ≥2 abnormal domains; 2–3 moderate deficits and 4–5 severe deficits. Clinical (Harvey Bradshaw Index >4/partial Mayo Score ≥2) and biochemical (C-reactive protein ≥10 mg/L and/or fecal calprotectin ≥250 μg/g) disease activity and disease burden (short Inflammatory Bowel Disease Questionnaire) were assessed. ResultsSomatic domain (51.6%) and activities of daily living (43.0%) were most frequently impaired. A total of 160 (39.5%) patients had moderate deficits in their geriatric assessment; 32 (7.9%) severe. Clinical and biochemical disease activity associated with deficits (clinical: adjusted odds ratio, 2.191; 95% confidence interval, 1.284–3.743; P = .004; biochemical: adjusted odds ratio, 3.358; 95% confidence interval, 1.936–5.825; P < .001). Deficits in geriatric assessment independently associate with lower health-related quality of life. ConclusionDeficits in geriatric assessment are highly prevalent in older patients with IBD. Patients with active disease are more prone to deficits, and deficits associate with lower health-related quality of life, indicating higher disease burden. Prospective data validating impact of frailty and geriatric assessment on outcomes are warranted to further improve treatment strategies.
Highlights
BACKGROUND & AIMSMETHODS: We aimed to perform geriatric assessment in older patients with inflammatory bowel disease (IBD) to evaluate which IBD characteristics associate with deficits in geriatric assessment and the impact of deficits on disease burden.A prospective multicenter cohort study including 405 consecutive outpatient patients with IBD aged ‡65 years
Abbreviations used in this paper: Activities of Daily Living (ADL), activities of daily living; CD, Crohn’s disease; CI, confidence interval; CRP, C-reactive protein; FCP, fecal calprotectin; HBI, Harvey Bradshaw Index; healthrelated quality of life (HRQoL), health-related quality of life; IBD, inflammatory bowel disease; IBD-U, IBD-unclassified; IQR, interquartile range; LUMC, Leiden University Medical Centre; pMS, partial Mayo score; sIBDQ, short Inflammatory Bowel Disease Questionnaire; UC, ulcerative colitis
Our findings underline the importance of assessing the presence of frailty in older patients with IBD, as the prevalence of geriatric deficits we found is high
Summary
BACKGROUND & AIMSMETHODS: We aimed to perform geriatric assessment in older patients with inflammatory bowel disease (IBD) to evaluate which IBD characteristics associate with deficits in geriatric assessment and the impact of deficits on disease burden (health-related quality of life).A prospective multicenter cohort study including 405 consecutive outpatient patients with IBD aged ‡65 years. METHODS: We aimed to perform geriatric assessment in older patients with inflammatory bowel disease (IBD) to evaluate which IBD characteristics associate with deficits in geriatric assessment and the impact of deficits on disease burden (health-related quality of life). Abbreviations used in this paper: ADL, activities of daily living; CD, Crohn’s disease; CI, confidence interval; CRP, C-reactive protein; FCP, fecal calprotectin; HBI, Harvey Bradshaw Index; HRQoL, health-related quality of life; IBD, inflammatory bowel disease; IBD-U, IBD-unclassified; IQR, interquartile range; LUMC, Leiden University Medical Centre; pMS, partial Mayo score; sIBDQ, short Inflammatory Bowel Disease Questionnaire; UC, ulcerative colitis. Clinical (Harvey Bradshaw Index >4/partial Mayo Score >2) and biochemical (C-reactive protein ‡10 mg/L and/or fecal calprotectin ‡250 mg/g) disease activity and disease burden (short Inflammatory Bowel Disease Questionnaire) were assessed.
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