Crohn's Disease of the Elderly: Unique Biology and Therapeutic Efficacy and Safety

Gastroenterol Clin North Am. 2022 Jun;51(2):425-440. doi: 10.1016/j.gtc.2021.12.014. Epub 2022 Apr 27.

Abstract

The incidence and prevalence of inflammatory bowel disease (IBD) is increasing in the elderly population. Compared with patients with onset during younger years, patients with elderly-onset IBD have a distinct clinical presentation, disease phenotype, and natural history. Genetics contribute less to pathogenesis of disease, whereas aging-related biological changes, such as immunosenescence and dysbiosis, are associated with elderly-onset IBD. Frailty is an increasingly recognized predictor of adverse outcomes. As an increasingly wider array of biologic and small molecule therapeutic options becomes available, data regarding efficacy and safety of these agents in patients are paramount given the unique characteristics of this population.

Keywords: COVID-19; Crohn’s disease; Elderly; Frailty; Inflammatory bowel disease; Phenotype; Treatment.

Publication types

  • Review

MeSH terms

  • Aged
  • Biology
  • Colitis, Ulcerative* / drug therapy
  • Crohn Disease* / drug therapy
  • Crohn Disease* / epidemiology
  • Humans
  • Incidence
  • Inflammatory Bowel Diseases* / therapy