Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy -
Minerva Gastroenterol (Torino). 2024 Mar;70(1):79-88. doi: 10.23736/S2724-5985.21.02886-2. Epub 2021 May 14.
Inflammatory bowel diseases (IBDs) are characterized by a multifactorial clinical picture, in which age-related physical, functional and psychological symptoms may coexist. The accurate evaluation and identification of such symptomatology acquires considerable importance in the context of older adults, since those core factors typical of IBD may also expose older patients to an increased risk for age-related negative outcomes, such as frailty and disability. The purpose of the present review was to provide an updated overview on the evaluation and management of IBD in the elderly population, with regard to fatigue, sarcopenia, and frailty. The assessment of fatigue might contribute to the identification of early symptoms of IBD, such as pain and mood disorders, which should be treated timely to offer elderly patient a better quality of life. Similarly, an accurate evaluation of sarcopenia might represent a useful Prognostic Index to identify those patients at risk of developing physical frailty. Frailty in IBD should be evaluated not only in relation to the occurrence of negative outcomes, but also should be considered itself as an outcome itself in IBD. A recommendation for future research on this topic might be the implementation of randomized trials, which include older adults and evaluate fatigue, sarcopenia, and frailty. Similarly, the development of tailored intervention programs, based on both physical and psychological outcomes, with the purpose of improving patients' adaptation to the disease, and monitoring the evolution of symptoms and the response to therapies over time, should be encouraged.
炎症性肠病（IBD）的临床表现具有多因素特征，其中与年龄相关的身体、功能和心理症状可能同时存在。在老年人中，准确评估和识别这些症状具有重要意义，因为 IBD 的核心因素也可能使老年患者面临与年龄相关的负面后果（如虚弱和残疾）的风险增加。本综述的目的是提供老年人 IBD 中疲劳、肌肉减少症和虚弱的评估和管理的最新概述。评估疲劳可能有助于识别 IBD 的早期症状，如疼痛和情绪障碍，应及时治疗这些症状，以提高老年患者的生活质量。同样，准确评估肌肉减少症可能是识别那些有发生身体虚弱风险的患者的有用预后指标。IBD 中的虚弱不仅应根据负面结果的发生进行评估，而且应将其本身视为 IBD 中的一个结果。关于这个主题的未来研究建议可能是实施随机试验，其中包括老年人，并评估疲劳、肌肉减少症和虚弱。同样，应该鼓励制定基于身体和心理结果的量身定制的干预计划，目的是改善患者对疾病的适应能力，并监测症状的演变和对治疗的反应随时间的变化。
