Clinical Characteristics of Patients with Elderly-onset Crohn's Disease
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0411
- VernacularTitle:老年起病克罗恩病患者的临床特征
- Author:
Jue LIN
1
;
Min ZHI
1
;
Min ZHANG
1
Author Information
1. 中山大学附属第六医院消化内科//广东省结直肠盆底疾病研究重点实验室//人体微生态与老年慢性疾病教育部重点实验室,广东 广州 510655
- Publication Type:Journal Article
- Keywords:
Crohn's disease;
elderly-onset;
clinical characteristic;
diagnostic delay;
prognosis
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2025;46(4):651-659
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]The incidence and disease burden of elderly-onset Crohn's disease(EOCD)have been increasing annually,yet prior research remains limited.This study analyzed the clinical characteristics of EOCD patients and compared them with those of non-elderly-onset Crohn's disease(non-EOCD)patients,aiming to provide evidence for the clinical diagnosis and treatment of EOCD.[Methods]A single-center retrospective case-control study was conducted among enrolled patients with Crohn's disease(CD)diagnosed at the Sixth Affiliated Hospital of Sun Yat-sen University between July 2011 and July 2020.Propensity score matching(1∶3)was applied to eliminate confounding effects between groups.Multidimensional comparisons were performed to reveal differences in disease phenotype,comorbidity spectrum,treatment response,prognosis,and healthcare resource utilization between the elderly-onset(EO)group(≥60 years,n=17)and the non-elderly-onset(non-EO)group(18-59 years,n=51).[Results]At initial diagnosis,the EO group predominantly presented with L3(70.6%),B1(58.8%),and mild activity(76.5%),without upper gastrointestinal involvement.Compared with the non-EO group,the EO group had a significantly longer diagnostic delay(21.9 vs.14.8 months,P=0.019),a lower rate of perianal lesions(11.8%vs.54.9%,P=0.002),but a higher prevalence of comorbidities such as hypertension(23.5%vs.0%),chronic kidney disease(11.8%vs.2.0%),and malignancy history(17.6%vs.0%).During an average follow-up of 72.0±33.7 months,the EO group reported higher rates of abdominal pain(35.3%vs.17.6%,P＜0.05),bloating(11.8%vs.3.9%,P＜0.05),weight loss(11.8%vs.3.9%,P＜0.05),longer intervals between dose adjustments(33.56±33.91 vs.21.41±30.12 months,P＜0.05),and more annual hospitalizations(1.12 vs.0.22,P＜0.05).[Conclusions]EOCD patients primarily exhibit mild disease activity and have fewer risk factors for poor prognostic such as upper gastrointestinal involvement and perianal lesions,resulting in a relatively stable disease phenotype.However,EOCD is associated with significant diagnostic delays,more comorbidities,suboptimal symptom control,and a higher potential of healthcare resource utilization.These findings underscore the need to enhance clinicians'awareness of EOCD and implement a comprehensive management model with multidisciplinary collaboration.
