title: Natural history of elderly-onset inflammatory bowel disease: a population-based cohort study.
abstract: Data on the natural history of elderly-onset inflammatory bowel disease (IBD) are scarce.
  
  
  METHODS
  In a French population-based cohort we identified 841 IBD patients >60 years of age at diagnosis from 1988 to 2006, including 367 Crohn's disease (CD) and 472 ulcerative colitis (UC).
  
  
  RESULTS
  Median age at diagnosis was similar for CD (70 years (IQR: 65-76)) and UC (69 years (64-74)). Median follow-up was 6 years (2-11) for both diseases. At diagnosis, in CD, pure colonic disease (65%) and inflammatory behaviour (78%) were the most frequent phenotype. At maximal follow-up digestive extension and complicated behaviour occurred in 8% and 9%, respectively. In UC, 29% of patients had proctitis, 45% left-sided and 26% extensive colitis without extension during follow-up in 84%. In CD cumulative probabilities of receiving corticosteroids (CSs), immunosuppressants (ISs) and anti tumor necrosis factor therapy were respectively 47%, 27% and 9% at 10 years. In UC cumulative probabilities of receiving CS and IS were 40% and 15%, respectively at 10 years. Cumulative probabilities of surgery at 1 year and 10 years were 18% and 32%, respectively in CD and 4% and 8%, respectively in UC. In CD complicated behaviour at diagnosis (HR: 2.6; 95% CI 1.5 to 4.6) was associated with an increased risk for surgery while CS was associated with a decreased risk (HR: 0.5; 0.3 to 0.8). In UC CS was associated with an increased risk (HR: 2.2; 1.1 to 4.6) for colectomy.
  
  
  CONCLUSIONS
  Clinical course is mild in elderly-onset IBD patients. This information would need to be taken into account by physicians when therapeutic strategies are established.
authors: Gastroenterology Unit, EPIMAD Registry, Rouen University and Hospital, , Rouen, France.
authors: Cloé
authors: C
authors: Charpentier
authors: Julia
authors: J
authors: Salleron
authors: Guillaume
authors: G
authors: Savoye
authors: Mathurin
authors: M
authors: Fumery
authors: Véronique
authors: V
authors: Merle
authors: Jean-Eric
authors: JE
authors: Laberenne
authors: Francis
authors: F
authors: Vasseur
authors: Jean-Louis
authors: JL
authors: Dupas
authors: Antoine
authors: A
authors: Cortot
authors: Luc
authors: L
authors: Dauchet
authors: Laurent
authors: L
authors: Peyrin-Biroulet
authors: Eric
authors: E
authors: Lerebours
authors: Jean-Frédéric
authors: JF
authors: Colombel
authors: Corinne
authors: C
authors: Gower-Rousseau
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents
keywords: Elderly; Epidemiology; Inflammatory Bowel Disease