Na Soo-Young
Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
Korean J Gastroenterol. 2021 May 25;77(5):231-240. doi: 10.4166/kjg.2021.077.
As the incidence of inflammatory bowel disease (IBD) are increasing with an ageing population, the incidence and prevalence of IBD in the elderly continue to increase. Older IBD patients can be classified into two groups; elderly-onset IBD patients and elderly IBD patients who were diagnosed at a young age and transitioning into advanced age. Clinicians must consider elderly-onset specific phenotypes or prognosis and age-related concerns in the treatment of elderly IBD patients. There is a paucity of evidence whether there is a different disease process when IBD occurs in older age yet. Clinicians may expect similar therapeutic effects in older and younger patients in drug selection, but since older patients are often excluded from clinical trials, evidence to support this assumption is currently lacking. Also, the risk of side effects may be higher in elderly patients. Therefore, when making management decisions in the elderly, clinicians should assess an individual's frailty rather than only considering an individual's chronological and biological age. Knowing specific requirements for managing older IBD patients may help to make an appropriate therapeutic strategy for this patient group.
随着炎症性肠病(IBD)的发病率随着人口老龄化而上升,老年IBD的发病率和患病率持续增加。老年IBD患者可分为两组;老年起病的IBD患者和年轻时被诊断出并步入老年的IBD患者。临床医生在治疗老年IBD患者时必须考虑老年起病的特定表型或预后以及与年龄相关的问题。目前仍缺乏证据表明IBD在老年时发生是否存在不同的疾病过程。临床医生在药物选择上可能期望老年患者和年轻患者有相似的治疗效果,但由于老年患者经常被排除在临床试验之外,目前缺乏支持这一假设的证据。此外,老年患者出现副作用的风险可能更高。因此,在为老年人制定管理决策时,临床医生应评估个体的虚弱程度,而不仅仅是考虑个体的实际年龄和生物学年龄。了解管理老年IBD患者的具体要求可能有助于为该患者群体制定适当的治疗策略。