Deficits in Geriatric Assessment Associate With Disease Activity and Burden in Older Patients With Inflammatory Bowel Disease

Vera E R Asscher; Sanne N Waars; Andrea E van der Meulen-de Jong; Rogier J L Stuyt; A Martine C Baven-Pronk; Sander van der Marel; Rutger J Jacobs; Jeoffrey J L Haans; Lennart J Meijer; Jacqueline D Klijnsma-Slagboom; Marijn H Duin; Milou E R Peters; Felicia V Y L Lee-Kong; Nanda E Provoost; Femke Tijdeman; Kenan T van Dijk; Monse W M Wieland; Mirre G M Verstegen; Melissa E van der Meijs; Annemijn D I Maan; Floor J van Deudekom; Simon P Mooijaart; P W Jeroen Maljaars

doi:10.1016/j.cgh.2021.06.015

Deficits in Geriatric Assessment Associate With Disease Activity and Burden in Older Patients With Inflammatory Bowel Disease

Vera E R Asscher^*, Sanne N Waars, Andrea E van der Meulen-de Jong, Rogier J L Stuyt, A Martine C Baven-Pronk, Sander van der Marel, Rutger J Jacobs, Jeoffrey J L Haans, Lennart J Meijer, Jacqueline D Klijnsma-Slagboom, Marijn H Duin, Milou E R Peters, Felicia V Y L Lee-Kong, Nanda E Provoost, Femke Tijdeman, Kenan T van Dijk, Monse W M Wieland, Mirre G M Verstegen, Melissa E van der Meijs, Annemijn D I MaanFloor J van Deudekom, Simon P Mooijaart, P W Jeroen Maljaars

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

3 Citations (Web of Science)

Abstract

BACKGROUND & AIMS: We aimed to perform geriatric assessment in older patients with inflammatory bowel disease (IBD) to evaluate which IBD characteristics associate with deficits in geriatric assessment and the impact of deficits on disease burden (health-related quality of life).

METHODS: A prospective multicenter cohort study including 405 consecutive outpatient patients with IBD aged ≥65 years. Somatic domain (comorbidity, polypharmacy, malnutrition), impairments in (instrumental) activities of daily living, physical capacity (handgrip strength, gait speed), and mental (depressive symptoms, cognitive impairment) and social domain (life-partner) were assessed. Deficits in geriatric assessment were defined as ≥2 abnormal domains; 2-3 moderate deficits and 4-5 severe deficits. Clinical (Harvey Bradshaw Index >4/partial Mayo Score >2) and biochemical (C-reactive protein ≥10 mg/L and/or fecal calprotectin ≥250 μg/g) disease activity and disease burden (short Inflammatory Bowel Disease Questionnaire) were assessed.

RESULTS: Somatic domain (51.6%) and activities of daily living (43.0%) were most frequently impaired. A total of 160 (39.5%) patients had moderate deficits in their geriatric assessment; 32 (7.9%) severe. Clinical and biochemical disease activity associated with deficits (clinical: adjusted odds ratio, 2.191; 95% confidence interval, 1.284-3.743; P = .004; biochemical: adjusted odds ratio, 3.358; 95% confidence interval, 1.936-5.825; P < .001). Deficits in geriatric assessment independently associate with lower health-related quality of life.

CONCLUSION: Deficits in geriatric assessment are highly prevalent in older patients with IBD. Patients with active disease are more prone to deficits, and deficits associate with lower health-related quality of life, indicating higher disease burden. Prospective data validating impact of frailty and geriatric assessment on outcomes are warranted to further improve treatment strategies.

Original language	English
Pages (from-to)	E1006-E1021
Number of pages	16
Journal	Clinical gastroenterology and hepatology
Volume	20
Issue number	5
Early online date	19 Jun 2021
DOIs	https://doi.org/10.1016/j.cgh.2021.06.015
Publication status	Published - May 2022

Keywords

CONSENSUS
CROHNS-DISEASE
Crohn's Disease
Elderly
FRAILTY
Frailty
Geriatric Assessment
INDEX
NUTRITION
PEOPLE
Ulcerative Colitis

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Asscher, V. E. R., Waars, S. N., van der Meulen-de Jong, A. E., Stuyt, R. J. L., Baven-Pronk, A. M. C., van der Marel, S., Jacobs, R. J., Haans, J. J. L., Meijer, L. J., Klijnsma-Slagboom, J. D., Duin, M. H., Peters, M. E. R., Lee-Kong, F. V. Y. L., Provoost, N. E., Tijdeman, F., van Dijk, K. T., Wieland, M. W. M., Verstegen, M. G. M., van der Meijs, M. E., ... Maljaars, P. W. J. (2022). Deficits in Geriatric Assessment Associate With Disease Activity and Burden in Older Patients With Inflammatory Bowel Disease. Clinical gastroenterology and hepatology, 20(5), E1006-E1021. https://doi.org/10.1016/j.cgh.2021.06.015

@article{4933f01573b342b7833ede83e2dbeefc,

title = "Deficits in Geriatric Assessment Associate With Disease Activity and Burden in Older Patients With Inflammatory Bowel Disease",

abstract = "BACKGROUND & AIMS: We aimed to perform geriatric assessment in older patients with inflammatory bowel disease (IBD) to evaluate which IBD characteristics associate with deficits in geriatric assessment and the impact of deficits on disease burden (health-related quality of life).METHODS: A prospective multicenter cohort study including 405 consecutive outpatient patients with IBD aged ≥65 years. Somatic domain (comorbidity, polypharmacy, malnutrition), impairments in (instrumental) activities of daily living, physical capacity (handgrip strength, gait speed), and mental (depressive symptoms, cognitive impairment) and social domain (life-partner) were assessed. Deficits in geriatric assessment were defined as ≥2 abnormal domains; 2-3 moderate deficits and 4-5 severe deficits. Clinical (Harvey Bradshaw Index >4/partial Mayo Score >2) and biochemical (C-reactive protein ≥10 mg/L and/or fecal calprotectin ≥250 μg/g) disease activity and disease burden (short Inflammatory Bowel Disease Questionnaire) were assessed.RESULTS: Somatic domain (51.6%) and activities of daily living (43.0%) were most frequently impaired. A total of 160 (39.5%) patients had moderate deficits in their geriatric assessment; 32 (7.9%) severe. Clinical and biochemical disease activity associated with deficits (clinical: adjusted odds ratio, 2.191; 95% confidence interval, 1.284-3.743; P = .004; biochemical: adjusted odds ratio, 3.358; 95% confidence interval, 1.936-5.825; P < .001). Deficits in geriatric assessment independently associate with lower health-related quality of life.CONCLUSION: Deficits in geriatric assessment are highly prevalent in older patients with IBD. Patients with active disease are more prone to deficits, and deficits associate with lower health-related quality of life, indicating higher disease burden. Prospective data validating impact of frailty and geriatric assessment on outcomes are warranted to further improve treatment strategies.",

keywords = "CONSENSUS, CROHNS-DISEASE, Crohn's Disease, Elderly, FRAILTY, Frailty, Geriatric Assessment, INDEX, NUTRITION, PEOPLE, Ulcerative Colitis",

author = "Asscher, {Vera E R} and Waars, {Sanne N} and {van der Meulen-de Jong}, {Andrea E} and Stuyt, {Rogier J L} and Baven-Pronk, {A Martine C} and {van der Marel}, Sander and Jacobs, {Rutger J} and Haans, {Jeoffrey J L} and Meijer, {Lennart J} and Klijnsma-Slagboom, {Jacqueline D} and Duin, {Marijn H} and Peters, {Milou E R} and Lee-Kong, {Felicia V Y L} and Provoost, {Nanda E} and Femke Tijdeman and {van Dijk}, {Kenan T} and Wieland, {Monse W M} and Verstegen, {Mirre G M} and {van der Meijs}, {Melissa E} and Maan, {Annemijn D I} and {van Deudekom}, {Floor J} and Mooijaart, {Simon P} and Maljaars, {P W Jeroen}",

year = "2022",

month = may,

doi = "10.1016/j.cgh.2021.06.015",

language = "English",

volume = "20",

pages = "E1006--E1021",

journal = "Clinical gastroenterology and hepatology",

issn = "1542-3565",

publisher = "Elsevier Science",

number = "5",

}

Asscher, VER, Waars, SN, van der Meulen-de Jong, AE, Stuyt, RJL, Baven-Pronk, AMC, van der Marel, S, Jacobs, RJ, Haans, JJL, Meijer, LJ, Klijnsma-Slagboom, JD, Duin, MH, Peters, MER, Lee-Kong, FVYL, Provoost, NE, Tijdeman, F, van Dijk, KT, Wieland, MWM, Verstegen, MGM, van der Meijs, ME, Maan, ADI, van Deudekom, FJ, Mooijaart, SP & Maljaars, PWJ 2022, 'Deficits in Geriatric Assessment Associate With Disease Activity and Burden in Older Patients With Inflammatory Bowel Disease', Clinical gastroenterology and hepatology, vol. 20, no. 5, pp. E1006-E1021. https://doi.org/10.1016/j.cgh.2021.06.015

Deficits in Geriatric Assessment Associate With Disease Activity and Burden in Older Patients With Inflammatory Bowel Disease. / Asscher, Vera E R; Waars, Sanne N; van der Meulen-de Jong, Andrea E et al.

In: Clinical gastroenterology and hepatology, Vol. 20, No. 5, 05.2022, p. E1006-E1021.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Deficits in Geriatric Assessment Associate With Disease Activity and Burden in Older Patients With Inflammatory Bowel Disease

AU - Asscher, Vera E R

AU - Waars, Sanne N

AU - van der Meulen-de Jong, Andrea E

AU - Stuyt, Rogier J L

AU - Baven-Pronk, A Martine C

AU - van der Marel, Sander

AU - Jacobs, Rutger J

AU - Haans, Jeoffrey J L

AU - Meijer, Lennart J

AU - Klijnsma-Slagboom, Jacqueline D

AU - Duin, Marijn H

AU - Peters, Milou E R

AU - Lee-Kong, Felicia V Y L

AU - Provoost, Nanda E

AU - Tijdeman, Femke

AU - van Dijk, Kenan T

AU - Wieland, Monse W M

AU - Verstegen, Mirre G M

AU - van der Meijs, Melissa E

AU - Maan, Annemijn D I

AU - van Deudekom, Floor J

AU - Mooijaart, Simon P

AU - Maljaars, P W Jeroen

PY - 2022/5

Y1 - 2022/5

N2 - BACKGROUND & AIMS: We aimed to perform geriatric assessment in older patients with inflammatory bowel disease (IBD) to evaluate which IBD characteristics associate with deficits in geriatric assessment and the impact of deficits on disease burden (health-related quality of life).METHODS: A prospective multicenter cohort study including 405 consecutive outpatient patients with IBD aged ≥65 years. Somatic domain (comorbidity, polypharmacy, malnutrition), impairments in (instrumental) activities of daily living, physical capacity (handgrip strength, gait speed), and mental (depressive symptoms, cognitive impairment) and social domain (life-partner) were assessed. Deficits in geriatric assessment were defined as ≥2 abnormal domains; 2-3 moderate deficits and 4-5 severe deficits. Clinical (Harvey Bradshaw Index >4/partial Mayo Score >2) and biochemical (C-reactive protein ≥10 mg/L and/or fecal calprotectin ≥250 μg/g) disease activity and disease burden (short Inflammatory Bowel Disease Questionnaire) were assessed.RESULTS: Somatic domain (51.6%) and activities of daily living (43.0%) were most frequently impaired. A total of 160 (39.5%) patients had moderate deficits in their geriatric assessment; 32 (7.9%) severe. Clinical and biochemical disease activity associated with deficits (clinical: adjusted odds ratio, 2.191; 95% confidence interval, 1.284-3.743; P = .004; biochemical: adjusted odds ratio, 3.358; 95% confidence interval, 1.936-5.825; P < .001). Deficits in geriatric assessment independently associate with lower health-related quality of life.CONCLUSION: Deficits in geriatric assessment are highly prevalent in older patients with IBD. Patients with active disease are more prone to deficits, and deficits associate with lower health-related quality of life, indicating higher disease burden. Prospective data validating impact of frailty and geriatric assessment on outcomes are warranted to further improve treatment strategies.

AB - BACKGROUND & AIMS: We aimed to perform geriatric assessment in older patients with inflammatory bowel disease (IBD) to evaluate which IBD characteristics associate with deficits in geriatric assessment and the impact of deficits on disease burden (health-related quality of life).METHODS: A prospective multicenter cohort study including 405 consecutive outpatient patients with IBD aged ≥65 years. Somatic domain (comorbidity, polypharmacy, malnutrition), impairments in (instrumental) activities of daily living, physical capacity (handgrip strength, gait speed), and mental (depressive symptoms, cognitive impairment) and social domain (life-partner) were assessed. Deficits in geriatric assessment were defined as ≥2 abnormal domains; 2-3 moderate deficits and 4-5 severe deficits. Clinical (Harvey Bradshaw Index >4/partial Mayo Score >2) and biochemical (C-reactive protein ≥10 mg/L and/or fecal calprotectin ≥250 μg/g) disease activity and disease burden (short Inflammatory Bowel Disease Questionnaire) were assessed.RESULTS: Somatic domain (51.6%) and activities of daily living (43.0%) were most frequently impaired. A total of 160 (39.5%) patients had moderate deficits in their geriatric assessment; 32 (7.9%) severe. Clinical and biochemical disease activity associated with deficits (clinical: adjusted odds ratio, 2.191; 95% confidence interval, 1.284-3.743; P = .004; biochemical: adjusted odds ratio, 3.358; 95% confidence interval, 1.936-5.825; P < .001). Deficits in geriatric assessment independently associate with lower health-related quality of life.CONCLUSION: Deficits in geriatric assessment are highly prevalent in older patients with IBD. Patients with active disease are more prone to deficits, and deficits associate with lower health-related quality of life, indicating higher disease burden. Prospective data validating impact of frailty and geriatric assessment on outcomes are warranted to further improve treatment strategies.

KW - CONSENSUS

KW - CROHNS-DISEASE

KW - Crohn's Disease

KW - Elderly

KW - FRAILTY

KW - Frailty

KW - Geriatric Assessment

KW - INDEX

KW - NUTRITION

KW - PEOPLE

KW - Ulcerative Colitis

U2 - 10.1016/j.cgh.2021.06.015

DO - 10.1016/j.cgh.2021.06.015

M3 - Article

C2 - 34153476

SN - 1542-3565

VL - 20

SP - E1006-E1021

JO - Clinical gastroenterology and hepatology

JF - Clinical gastroenterology and hepatology

IS - 5

ER -