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
N1 - Copyright © 2021 by the AGA Institute. Published by Elsevier, Inc. Published by Elsevier Inc. All rights reserved.
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 -