Hospital Therezinha de Jesus, Divisão de Cirurgia Colorretal, Juiz de Fora, MG, Brasil.
Universidade Federal de Juiz de Fora, Departamento de Cirurgia, Juiz de Fora, MG, Brasil.
Arq Gastroenterol. 2024 Jul 19;61:e24017. doi: 10.1590/S0004-2803.24612024-017. eCollection 2024.
Inflammatory bowel disease (IBD), represented by Crohn's disease (CD) and ulcerative colitis (UC), is a chronic condition that affects all age groups, predominantly in young individuals. Currently, an increase in the prevalence of IBD has been documented, in parallel with the increase in the elderly population. The scarce number of studies that better characterize the impact of IBD on Quality of Life (QoL) in the elderly motivated the present study.
To evaluate the impact of IBD on the QoL of elderly people treated at a Tertiary IBD Center.
Prospective cross-sectional study that included elderly patients (age ≥60 years) with quiescent or mildly active IBD treated at the HU-UFJF IBD Center between March 2019 and December 2022. Elderly companions without severe comorbidities who attended the consultation with the patients were included as a control group. Sociodemographic and IBD-related characteristics were recorded. QoL was assessed using previously validated questionnaires (WHOQOL-BREF and IBDQ). Patients with IBD with moderate to severe activity, history of recent or imminent hospitalization, serious or opportunistic infections in the last 6 months, previous neoplasia, dementia, and difficulty understanding/fulfilling the questionnaires were excluded.
A total of 123 patients were included (74 with IBD and 49 in the control group), with a mean age of 67±6.2 years, 52.7% with CD, and 47.3% with UC. Mild disease activity was observed in 31.1%. Both groups (IBD patients and control) were comparable based on age, sex, BMI, and the Charlson Comorbidity Index. Patients with IBD and controls had similar QoL scores in the different domains assessed by the WHOQOL-BREF. On the other hand, when evaluating the general facet of QoL, IBD patients had significantly lower scores in General QoL (3.71±0.87 versus 4.02±0.62, respectively; P=0.021) and General Health (3.32±1.05 versus 3.69±0.94, respectively; P=0.035). The presence of mildly active IBD negatively impacted the general health score (2.91±0.99 versus 3.47±1.04, respectively; P=0.035) and the physical domain of the WHOQOL-BREF (12.27±2.63 versus 13.86±2.61, respectively; P=0.019) when compared to patients in remission. Conversely, no impact on QoL was observed with the Application of the IBDQ questionnaire regarding the type of the disease (161±38.5 versus 163.1±42.6 for CD and UC, respectively; P=0.84) or the presence of activity (152.5±38.8 versus 166.4±40.5, respectively; P=0.17).
No statistically significant differences were found between elderly patients with mildly active or quiescent IBD and elderly patients without IBD when observing global QoL scores. However, IBD negatively impacted the general facet of QoL, just as mild activity was associated with lower scores in general health and the physical domain assessed by the WHOQOL-BREF. Patients with IBD treated with biological therapy had better Qol than those on conventional therapy. Future studies are needed to choose the most appropriate tool for assessing QoL in this population.
炎症性肠病（IBD），包括克罗恩病（CD）和溃疡性结肠炎（UC），是一种影响所有年龄段的慢性疾病，主要发生在年轻人中。目前，随着老年人口的增加，IBD 的患病率也在增加。由于缺乏更好地描述 IBD 对老年患者生活质量（QoL）影响的研究，因此进行了本研究。
评估三级 IBD 中心治疗的老年 IBD 患者的生活质量（QoL）的影响。
这是一项前瞻性的横断面研究，纳入了 2019 年 3 月至 2022 年 12 月在 HU-UFJF IBD 中心接受治疗的年龄≥60 岁、病情稳定或轻度活动的 IBD 老年患者（年龄≥60 岁）和病情稳定或轻度活动的 IBD 老年患者（年龄≥60 岁）。纳入了与患者一起就诊且无严重合并症的老年患者作为对照组。记录了患者的社会人口学和 IBD 相关特征。使用先前验证的问卷（WHOQOL-BREF 和 IBDQ）评估 QoL。排除了中度至重度活动、近期或即将住院、过去 6 个月内有严重或机会性感染、既往有肿瘤、痴呆和难以理解/完成问卷的患者。
共纳入 123 例患者（74 例 IBD 患者和 49 例对照组），平均年龄 67±6.2 岁，52.7%为 CD，47.3%为 UC。观察到轻度疾病活动。两组（IBD 患者和对照组）在年龄、性别、BMI 和 Charlson 合并症指数方面无差异。在 WHOQOL-BREF 评估的不同领域，IBD 患者和对照组的 QoL 评分相似。另一方面，当评估总体 QoL 时，IBD 患者的总体 QoL（3.71±0.87 与 4.02±0.62，P=0.021）和总体健康（3.32±1.05 与 3.69±0.94，P=0.035）评分明显较低。轻度活动的 IBD 存在对总体健康评分（2.91±0.99 与 3.47±1.04，P=0.035）和 WHOQOL-BREF 的身体领域（12.27±2.63 与 13.86±2.61，P=0.019）产生负面影响与缓解期患者相比。相反，IBDQ 问卷在评估疾病类型（CD 为 161±38.5，UC 为 163.1±42.6；P=0.84）或活动状态（152.5±38.8，UC 为 166.4±40.5；P=0.17）时，对 QoL 没有影响。
在观察总体 QoL 评分时，轻度活动或缓解期 IBD 老年患者与无 IBD 的老年患者之间未发现统计学差异。然而，IBD 对总体 QoL 产生负面影响，轻度活动与总体健康和 WHOQOL-BREF 评估的身体领域的评分较低有关。接受生物治疗的 IBD 患者的 QoL 比接受常规治疗的患者更好。未来的研究需要选择最适合评估该人群生活质量的工具。
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