Background: The reported prevalence of ulcerative colitis (UC) in patients aged 60 years or older is 15%. Several studies have evaluated the differences between disease course in younger and older patients.
Methods: Retrospective analysis of patients with UC followed in an inflammatory bowel disease outpatient clinic, with follow up >2 years. Patients were divided in 2 groups; patients with UC diagnosed before the age of 60 years-old (adult-onset UC) and patients with diagnosis with ≥60 years (late-onset UC). Demographic data, disease extent, colectomy rates, need for hospitalization, treatment and infections were evaluated and compared between the two groups. Statistical analysis performed using SPSS 21, considering statistical significance, p<0.05.
Results: 115 patients, 60 males, 29 patients (25%) in the late-onset group. Mean time follow-up was 12,7 years in the adult-onset versus 9,8 years in the late-onset group. There were no differences between the 2 groups regarding family history of IBD (p=0.712) and smoking habits (p=0.193). Regarding disease extent, in the adult-onset group 25% had proctitis, 48% had left-sided disease and 27% had extensive disease versus 28%, 48% and 24% respectively in the late-onset group (p=0.932). Progression of disease extent occurred in 9.6% in the late-onset group and 10.3% in the late-onset group (p=0.912). Colectomy was performed in only 1 patient, with adult-onset UC.
There were no differences in the need for hospitalization (29% in the adult-onset; 21% in the late-onset group; p=0.379)or in the corticosteroids use (57% versus 48% respectively, p=0.315). There was a significant higher use of immunosuppression in the adult-onset group (27%) than in the late-onset group (6.9%), p=0.025. Biologic therapeutic was used in 10.6% in the early onset group and 3.4% in the late-onset group but there was no statistical difference p=0.243. There were no differences in the Cytomegalovirus and Clostridium difficile infections (p=0.658; p=0.904, respectively).
Conclusions: Although several studies have shown that late-onset UC has a more favorable clinical course, in our series there were no significant difference in the disease course between the late-onset and adult onset, except for the use of immunossuppression, which was higher in the adult-onset group.