OBJECTIVES: Late-onset Crohn's disease (CD) may show a distinctive pattern of expression. The aim of our study was to describe the incidence or presentation of CD in the elderly and compare the outcomes in patients < 60 years or > or = 60 years at diagnosis. METHODS: The study included a population based inception cohort of all incident CD cases diagnosed in Brittany (France) between 1994 and 1997. Sixty-three patients were > or = 60 years and 201 were < 60 years at diagnosis. The physicians managing the patients used standardized questionnaires to collect the study data. The questionnaires on outcomes and treatments were completed in 2002. RESULTS: In patients > or = 60 years, the annual incidence was 2.5 per 10 persons and clinical features were similar to those in younger patients, except for a higher rate of colon involvement. Among older patients, those with diverticula (29/63, 46%) were more likely to have granulomas (58% vs 33% of patients without diverticula, P < 0.04), but the diagnosis of CD was confirmed by lesions remote from the diverticula in most cases (23/29). Early resection rates were not higher in older patients, who were less likely to require immunosuppressants or re-admission for CD flares, as compared to younger patients. Five year mortality in older patients was 16% but was unrelated to CD. CONCLUSIONS: In Brittany, the age specific incidence, clinical features, and prognosis of CD among the elderly are comparable to those in younger individuals. Colon involvement is more common. Concomitant diverticular disease is common and should prompt a search for CD lesions at other sites to confirm the diagnosis. Older patients are less likely to require immunosuppressants or admission for flares.
OBJECTIVES: Late-onset Crohn's disease (CD) may show a distinctive pattern of expression. The aim of our study was to describe the incidence or presentation of CD in the elderly and compare the outcomes in patients < 60 years or > or = 60 years at diagnosis. METHODS: The study included a population based inception cohort of all incident CD cases diagnosed in Brittany (France) between 1994 and 1997. Sixty-three patients were > or = 60 years and 201 were < 60 years at diagnosis. The physicians managing the patients used standardized questionnaires to collect the study data. The questionnaires on outcomes and treatments were completed in 2002. RESULTS: In patients > or = 60 years, the annual incidence was 2.5 per 10 persons and clinical features were similar to those in younger patients, except for a higher rate of colon involvement. Among older patients, those with diverticula (29/63, 46%) were more likely to have granulomas (58% vs 33% of patients without diverticula, P < 0.04), but the diagnosis of CD was confirmed by lesions remote from the diverticula in most cases (23/29). Early resection rates were not higher in older patients, who were less likely to require immunosuppressants or re-admission for CD flares, as compared to younger patients. Five year mortality in older patients was 16% but was unrelated to CD. CONCLUSIONS: In Brittany, the age specific incidence, clinical features, and prognosis of CD among the elderly are comparable to those in younger individuals. Colon involvement is more common. Concomitant diverticular disease is common and should prompt a search for CD lesions at other sites to confirm the diagnosis. Older patients are less likely to require immunosuppressants or admission for flares.
Authors: Tomer Adar; David Faleck; Saranya Sasidharan; Kelly Cushing; Nienke Z Borren; Niharika Nalagatla; Ryan Ungaro; Wayne Sy; Samuel C Owen; Anish Patel; Benjamin L Cohen; Ashwin N Ananthakrishnan Journal: Aliment Pharmacol Ther Date: 2019-02-17 Impact factor: 8.171
Authors: Siddharth Singh; Larry W Stitt; Guangyong Zou; Reena Khanna; Parambir S Dulai; William J Sandborn; Brian G Feagan; Vipul Jairath Journal: Aliment Pharmacol Ther Date: 2019-03-19 Impact factor: 8.171
Authors: Ashwin N Ananthakrishnan; Hai Yun Shi; Whitney Tang; Cindy C Y Law; Joseph J Y Sung; Francis K L Chan; Siew C Ng Journal: J Crohns Colitis Date: 2016-02-29 Impact factor: 9.071
Authors: Mirjam Bueno de Mesquita; Marc Ferrante; Liesbet Henckaerts; Marie Joossens; Virginie Janssens; Tibor Hlavaty; Marie Pierik; Sofie Joossens; Nele Van Schuerbeek; Gert Van Assche; Paul Rutgeerts; Severine Vermeire; Ilse Hoffman Journal: Eur J Pediatr Date: 2008-08-01 Impact factor: 3.183