Ulcerative colitis: comparison between elderly and young adult patients and between elderly patients with late-onset and long-standing disease.

Dig Dis Sci. 2013 May;58(5):1306-12.

Matsumoto S, Miyatani H, Yoshida Y.

Department of Gastroenterology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, Saitama, 330-8503, Japan. s.w.himananon@ac.auone-net.jp

Abstract

BACKGROUND AND AIM: We examined the pathologies, treatment characteristics, and clinical course of elderly ulcerative colitis (UC) patients.

METHODS: Among 222 UC patients (127 men, 95 women; average age, 34 ± 16 years), we selected 109 with UC diagnosed between 20 and 39 years of age (young adult group) and 23 diagnosed at ≥ 60 years of age (elderly group). Moreover, 12 patients diagnosed between 60 and 64 years of age (late-onset group) and 6 patients aged ≥ 60 years diagnosed under 50 years old (long-standing group) were also extracted for sub-analysis. The clinical characteristics and course were compared among the groups.

RESULTS: The average age at onset was 29 ± 6 years in the young adult group and 66 ± 5 years in the elderly group. The frequency of immunomodulator or steroid use did not differ between the two groups. The comorbidity rate was 14.7 % in the young adult group and 69.6 % in the elderly group (P < .0001). Seven patients (58.3 %) in the late-onset UC group and none of the patients in the long-standing UC group were on steroid treatment. None of the patients in the long-standing UC group required hospitalization/surgery for UC exacerbation, while 3 (25.0 %) and 2 patients (16.7 %) in the late-onset group required hospitalization and surgery, respectively.

CONCLUSIONS: The comorbidity rate was significantly higher in the elderly group. Treatments did not differ significantly between the young adult and elderly groups. Therefore, it appears that the inflammation tends to subside with age in elderly patients with long-standing UC.

PMID: 23306844

 

Satohiro Matsumoto-1

Figure: Kaplan-Meier analysis of the cumulative incidence of hospitalization for UC exacerbation (A) and colectomy for UC exacerbation (B) in late-onset group and long-standing group.

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