The elderly IBD patient in the modern era: changing paradigms in risk stratification and therapeutic management

• Published in: Therapeutic Advances in Gastroenterology Vol. 14; p. 17562848211023399
• Main Authors: Hong, Simon J., Katz, Seymour
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 2021; Sage Publications Ltd; SAGE Publishing
• Subjects: Gastroenterology; Inflammatory bowel disease; Older people; Review; COVID-19; phenotype; frailty; treatment; elderly; ulcerative colitis; inflammatory bowel disease; Crohn’s disease
• ISSN: 1756-2848; 1756-283X; 1756-2848
• DOI: 10.1177/17562848211023399

The incidence and prevalence of inflammatory bowel disease (IBD) is rising in the elderly population. Compared with patients with onset during their 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 biological changes associated with aging including immunosenescence, dysbiosis, and frailty have a greater impact on disease outcomes. With the advent of an increasingly wider array of biologic and small-molecule therapeutic options, data regarding efficacy and safety of these agents in elderly IBD patients specifically are paramount, given the unique characteristics of this population.