title: IBD in the elderly population: results from a population-based study in Western Hungary, 1977-2008.
abstract: OBJECTIVE
  Limited data are available on the incidence and disease course of IBD in the elderly population. Our aim was to analyze the incidence and disease course of IBD according to the age at diagnosis in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008.
  
  
  METHODS
  Data of 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 SD 15.9 years; CD: 506, age at diagnosis: 31.5 SD 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed.
  
  
  RESULTS
  106 (11.6%) of UC patients and 21 (4.2%) of CD patients were diagnosed with >60 years of age. In UC, the incidence increased from 1.09 to 10.8/10(5) in the elderly, while CD increased to 3.04/10(5) in 2002-2007. In CD, colonic location (elderly: 61.9% vs. pediatric: 24.3%, p=0.001, and adults: 36.8%, p=0.02) and stenosing disease (elderly: 42.9% vs. pediatric: 14.9%, p=0.005, and adults: 19.5%, p=0.01) were more frequent in the elderly. A change in disease behavior was absent in the elderly, while in pediatric and adult CD population it was 20.3% (p=0.037), 19.8% (p=0.036) after 5 years. In UC, extensive disease was more frequent in pediatric patients compared to the elderly (p=0.003, OR: 2.73, 95%CI: 1.38-5.41). In addition, pediatric (57.3%, p<0.001, OR: 6.58; 95%CI: 3.22-12.9) and adult (39.8%, p<0.001, OR: 3.24; 95%CI: 1.91-5.49) patients required more often systemic steroids during follow-up compared to the elderly (17%). Proximal extension at 10 years was 11.6%, but time to extension was not different according to the age at onset.
  
  
  CONCLUSIONS
  Elderly patients represent an increasing proportion of the IBD population. Stenosing and colon-only disease were characteristic for elderly CD patients, while the disease course in UC was milder.
authors.affiliation: 1st Department of Medicine, Semmelweis University, Budapest, Hungary. kislakpet@bel1.sote.hu
authors.forename: Peter Laszlo
authors.initials: PL
authors.lastname: Lakatos
authors.forename: Gyula
authors.initials: G
authors.lastname: David
authors.forename: Tunde
authors.initials: T
authors.lastname: Pandur
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Erdelyi
authors.forename: Gabor
authors.initials: G
authors.lastname: Mester
authors.forename: Mihaly
authors.initials: M
authors.lastname: Balogh
authors.forename: Istvan
authors.initials: I
authors.lastname: Szipocs
authors.forename: Csaba
authors.initials: C
authors.lastname: Molnar
authors.forename: Erzsebet
authors.initials: E
authors.lastname: Komaromi
authors.forename: Lajos S
authors.initials: LS
authors.lastname: Kiss
authors.forename: Laszlo
authors.initials: L
authors.lastname: Lakatos
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D002648:Child; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000453:epidemiology*; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012737:Sex Factors; D055815:Young Adult