P799 Deficits in geriatric assessment are dynamic over 18 months and impacted by therapeutic treatment in older patients with Inflammatory Bowel Disease

Abstract

Abstract Background Frailty is a dynamic condition, however most previous studies in patients with IBD measured frailty at one point in time. Therefore, we aimed to study the course frailty, reflected by deficits measured in a geriatric assessment, during 18 months follow-up in older patients with Inflammatory Bowel Disease (IBD). In addition, we aimed to identify factors associated with changes in geriatric deficits over time. Methods In a prospective, multicenter cohort study, a geriatric assessment was performed at baseline and repeated after 18 months in 154 older patients with IBD. This geriatric assessment evaluated the presence of deficits in five geriatric domains: the somatic domain, mental domain, social domain, activities of daily living and physical capacity. The number and type of impaired domains at baseline were compared to follow-up. An increase in number of domains suggests worsening frailty, whereas a decrease in number of impaired domains suggests improving frailty. Logistic regression was performed to identify factors associated with change in number of domains. All analyses were adjusted for age, sex, type of IBD and educational level. Results During follow-up, 32.5% had increased and 26.0% decreased ≥ 1 in number of impaired domains, compared to baseline. At domain level, the proportion of patients with impaired activities of daily living decreased from 49.4% at baseline to 37.7% at follow-up (p-value=0.001). The proportion with impaired physical capacity increased from 14.3% to 26.0% (p-value=0.001). Use of systemic corticosteroid at baseline and/or the year prior to baseline was associated with an increase in impaired domains (aOR 3.00; 95% confidence interval (95% CI) 1.11-8.08; p-value= 0.030), while initiation of biological therapy was associated with a decrease in impaired domains at follow-up compared to baseline (aOR 4.92, 95%CI 1.41-17.15, p-value=0.013). Conclusion Geriatric deficits, reflecting levels of frailty, are dynamic over 18 months in older patients with IBD. Therapeutic IBD management appeared an important determinant for the longitudinal course of frailty. This study provides the first longitudinal data on the course of geriatric deficits, measured in a geriatric assessment, in older patients with IBD.