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

被引：21

作者：

Asscher, Vera E. R. ^{[1
]}

Waars, Sanne N. ^{[1
]}

Van Der Meulen-de Jong, Andrea E. ^{[1
]}

Stuyt, Rogier J. L. ^{[2
]}

Baven-Pronk, A. Martine C. ^{[3
]}

van Der Marel, Sander ^{[4
]}

Jacobs, Rutger J. ^{[5
]}

Haans, Jeoffrey J. L. ^{[6
]}

Meijer, Lennart J. ^{[1
]}

Klijnsma-Slagboom, Jacqueline D. ^{[1
]}

Duin, Marijn H. ^{[1
]}

Peters, Milou E. R. ^{[1
]}

Lee-Kong, Felicia V. Y. L. ^{[1
]}

Provoost, Nanda E. ^{[1
]}

Tijdeman, Femke ^{[1
]}

van Dijk, Kenan T. ^{[1
]}

Wieland, Monse W. M. ^{[6
]}

Verstegen, Mirre G. M. ^{[1
]}

van Der Meijs, Melissa E. ^{[1
]}

Maan, Annemijn D., I ^{[1
]}

van Deudekom, Floor J. ^{[7
]}

Mooijaart, Simon P. ^{[7
,8
]}

Maljaars, P. W. Jeroen ^{[1
]}

机构：

[1] Leiden Univ, Dept Gastroenterol & Hepatol, Med Ctr, Leiden, Netherlands

[2] HagaZiekenhuis, Dept Gastroenterol & Hepatol, The Hague, Netherlands

[3] Groene Hart Ziekenhuis, Dept Gastroenterol & Hepatol, Gouda, Netherlands

[4] Haaglanden Med Ctr, Dept Gastroenterol & Hepatol, The Hague, Netherlands

[5] Alrijne Hosp, Dept Gastroenterol & Hepatol, Leiden, Netherlands

[6] Maastricht Univ, Dept Gastroenterol & Hepatol, Med Ctr, Maastricht, Netherlands

[7] Leiden Univ, Dept Gerontol & Geriatr, Med Ctr, Leiden, Netherlands

[8] Inst Evidence Based Med Old Age IEMO, Leiden, Netherlands

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2022年 / 20卷 / 05期

关键词：

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

D O I：

10.1016/j.cgh.2021.06.015

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

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 mu g/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.

引用

页码：E1006 / E1021

页数：16

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