P0707 Impact of age of disease diagnosis on disease phenotype and severity in patients with Inflammatory Bowel Diseases

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Abstract Background Up to 15% of inflammatory bowel disease (IBD) patients are diagnosed after the age of 60 years. The aim of the study was to compare disease characteristics and management of IBD patients diagnosed before (adult onset-AO) or after the age of 60 years (elderly onset-EO). Methods Data of a prospective longitudinal registry of IBD patients followed in a tertiary center over a twelve-year period (2012-2024) were analyzed. Consecutive IBD patients with complete data at study entry were included. They were divided into two groups according to their age at disease diagnosis <60 (AO) and ≥ 60 (EΟ) years. The two groups were compared for their demographic and clinical characteristics, their treatment and outcomes (IBD related surgeries, development of malignancy, death). Results A total of 714 IBD patients were included in the study. EO had 109 (15.3%) and AO 605 (84.7%). Median (IQR) age at diagnosis was 31 (22.5-43) years in AO and 66 (62-71.2) years in EO (p<0.0001) while the median (IQR) disease duration was 13.5 (7-23) years in AO and 9 (4.25-13) years in EO respectively (p<0.0001). From the comparison of the 2 groups (EO vs AO), no association between age at diagnosis and disease type or gender was found. Extraintestinal manifestations (p=0.0009) and positive family history (p=0.001) were more frequent in AO. Age at diagnosis was associated with disease phenotype (p=0.006), location of NC (p=0.008) as well as perianal disease (EO more often had ileal location and inflammatory phenotype), while there were no differences in UC extension. Regarding therapy, there was a less frequent use of biological therapies, immunosuppressants and steroids (p<0.05) in EOs, while the use of budesonide was higher (p<0.0001) [Table 1]. During follow-up, more malignancies and deaths were recorded in EOs (p<0.0001), while IBD related surgeries were numerically more in AOs (16% vs 9%), but the difference was not statistically significant (p=0.059). Conclusion There are some distinct differences in clinical characteristics and therapeutic management between AO and EO patients with IBD. Further investigation on the role of age of diagnosis on disease phenotype is needed.