Director Inflammatory Bowel Disease Center, Aurora Healthcare, 975 Port Washington Rd, Grafton, WI, 53024, USA.
Division of General Internal Medicine, Milwaukee, WI, USA.
Dig Dis Sci. 2018 Jul;63(7):1787-1793. doi: 10.1007/s10620-018-5076-6. Epub 2018 Apr 30.
Health-related quality of life (HRQoL) is significantly impacted in patients with inflammatory bowel disease (IBD). Many studies have assessed HRQoL in patients of all ages, and few focus on the elderly.
To determine the influence of advanced age (> 65 years) and age at diagnosis on patients with IBD.
This is a retrospective study of prospectively collected data from a single IBD tertiary referral center. Patients had disease activity indices [Harvey-Bradshaw index (HBI), Ulcerative Colitis Disease Activity Index (UCDAI), and Short Inflammatory Bowel Disease Questionnaire (SIBDQ)] recorded during every clinic visit. Three groups of patients: > 65 years, 41-64 years, and < 40 years with > 5 SIBDQ entries were included. Influence of disease type, disease duration, extent of involvement, and comorbidities such as cardiovascular (CV) disease, pulmonary disease, diabetes mellitus (DM), and psychological disorders were noted as confounders. Statistical analysis was performed using ANOVA, Pearson correlation, and logistic regression model.
Disease severity indices significantly affected SIBDQ score in both Crohn's disease (CD) and ulcerative colitis (UC) (p < 0.001 for HBI in CD, p < 0.001 UCDAI in UC). Disease extent (p = 0.011) and psychological disorders (p < 0.001) significantly affected SIBDQ score in CD. Chronological age, age at diagnosis, disease duration, number of clinic visits, CV disease, pulmonary disease, and DM were not significant predictors of SIBDQ score (p > 0.05).
HRQoL was negatively influenced by disease extent and psychological disorders in CD but not in UC patients. Advanced age was not a predictor of poor HRQoL in both CD and UC.
炎症性肠病（IBD）患者的健康相关生活质量（HRQoL）受到显著影响。许多研究评估了所有年龄段患者的 HRQoL，而很少有研究关注老年人。
确定高龄（>65 岁）和诊断时年龄对 IBD 患者的影响。
这是一项对单中心炎症性肠病三级转诊中心前瞻性收集数据的回顾性研究。每位患者的就诊记录中均有疾病活动指数[哈维-布拉德肖指数（HBI）、溃疡性结肠炎疾病活动指数（UCDAI）和短炎症性肠病问卷（SIBDQ）]。纳入三组患者：>65 岁、41-64 岁和<40 岁，且 SIBDQ 记录>5 次。记录疾病类型、疾病持续时间、受累范围以及心血管疾病（CV）、肺部疾病、糖尿病（DM）和心理障碍等合并症作为混杂因素。采用方差分析、Pearson 相关性和逻辑回归模型进行统计学分析。
在克罗恩病（CD）和溃疡性结肠炎（UC）中，疾病严重程度指数均显著影响 SIBDQ 评分（CD 中 HBI，p<0.001；UC 中 UCDAI，p<0.001）。疾病范围（p=0.011）和心理障碍（p<0.001）显著影响 CD 患者的 SIBDQ 评分。而年龄、诊断时年龄、疾病持续时间、就诊次数、CV 疾病、肺部疾病和 DM 不是 SIBDQ 评分的显著预测因素（p>0.05）。
CD 患者的 HRQoL 受到疾病范围和心理障碍的负面影响，但 UC 患者则不然。高龄不是 CD 和 UC 患者 HRQoL 差的预测因素。
