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Practical Advice for the Management of Older Adults With Inflammatory Bowel Disease
Bharati D. Kochar, Seymour Katz, Adam S. Faye. The American Journal of Gastroenterology, 2025-10-01
Topic: Risk, prevention and care in population studies
These include segmental colitis associated with diverticulitis, colorectal cancer, radiation proctitis, ischemic and infectious colitis, as well as NSAID-induced enterocolitis (6,7). Clinical presentations differ among older adults with incident IBD compared to younger adults who develop IBD. In particular, rectal bleeding is more common among older adults with new-onset CD as compared to younger adults (12). There are also differing phenotypes and areas of disease involvement in older adults with new-onset CD; they are more likely to have isolated ileal or colonic disease but less likely to have ileocolonic disease as compared to younger adults (13). In a meta-analysis of population-based cohort studies, older adults who had new onset IBD, had similar clinical trajectories at 1, 5, and 10 years as compared to younger adults. Minimize diagnostic (and treatment) delays Perform a careful environmental and exposure history Some older adults may have less clinically significant IBD with advancing chronologic age, though many older adults still experience robust inflammation. Despite the number of steroid-sparing treatment options, older adults with IBD are significantly less likely to receive steroid-sparing therapy as compared to younger adults (14,18). This may in part explain why older adults with IBD have worse clinical outcomes as compared to younger adults; a finding which cannot be explained by differences in disease course. Older adults are more likely to be hospitalized, require surgical management, and have a disproportionately greater mortality from IBD as compared with younger adults (19–21). Thus, while the management of IBD has advanced overall, older adults have not benefited due to a lack of data. Additionally, older adults are at higher risk for adverse outcomes due to corticosteroids compared to younger adults (25). This pattern is consistent with findings from a Danish national registry study, which reported that individuals with IBD onset at or after age 70 had markedly lower use of immunomodulating therapy and surgery, even compared to those aged 60 and above (30). Additionally, thiopurine use is associated with nearly a twofold increased risk of non-melanoma skin cancer (NMSC), an especially important consideration in older adults who may already have a history of recurrent skin cancers (36). In a post-hoc analysis of the REACT trial, combination therapy was not associated with a higher risk of serious complications or death compared to c
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Kochar, B. D., Katz, S., & Faye, A. S. (2025). Practical Advice for the Management of Older Adults With Inflammatory Bowel Disease. The American Journal of Gastroenterology. https://doi.org/10.14309/ajg.0000000000003641.03
Vancouver
Kochar BD, Katz S, Faye AS. Practical Advice for the Management of Older Adults With Inflammatory Bowel Disease. The American Journal of Gastroenterology. 2025. doi:10.14309/ajg.0000000000003641.03. PMID: 41041995.
BibTeX
@article{kochar2025-41041995,
author = {Kochar, Bharati D. and Katz, Seymour and Faye, Adam S.},
title = {{Practical Advice for the Management of Older Adults With Inflammatory Bowel Disease}},
journal = {The American Journal of Gastroenterology},
year = {2025},
doi = {10.14309/ajg.0000000000003641.03},
pmid = {41041995},
url = {https://doi.org/10.14309/ajg.0000000000003641.03}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- These include segmental colitis associated with diverticulitis, colorectal cancer, radiation proctitis, ischemic and infectious colitis, as well as NSAID-induced enterocolitis (6,7).
- Clinical presentations differ among older adults with incident IBD compared to younger adults who develop IBD.
- In particular, rectal bleeding is more common among older adults with new-onset CD as compared to younger adults (12).
- There are also differing phenotypes and areas of disease involvement in older adults with new-onset CD; they are more likely to have isolated ileal or colonic disease but less likely to have ileocolonic disease as compared to younger adults (13).
- In a meta-analysis of population-based cohort studies, older adults who had new onset IBD, had similar clinical trajectories at 1, 5, and 10 years as compared to younger adults.
Why it matters
This review describes how older adults with inflammatory bowel disease differ from younger patients in symptoms and disease location, and notes they are less likely to receive steroid-sparing therapy. It does not address treating, curing, or preventing Alzheimer's disease.
Study details
- Study designmeta-analysis
- Participants123
- Effect size39.1%; or 0.6
- Evidence strengthHigh
How this study scored 59/100
Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies. We have no data on institution's track record, so that was left out: it earned 57 of the 97 points we could judge it on, which is 59 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (The American Journal of Gastroenterology) |
| Journal's citation record | 3 / 4 | The American Journal of Gastroenterology: journal h-index 335 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 123 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 1 / 7 | Cited 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Adam S. Faye: h-index 22 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41041995) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 57 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 57 of the 97 points we could judge it on is 59 out of 100. |
| Total | 59 / 100 | — |
What each of these 20 components measures, and what this score is not →
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