Observational studyBMJ open gastroenterology2026
Clinical characteristics and treatment patterns of elderly versus non-elderly adults with inflammatory bowel disease in Brazil: a cross-sectional study.
Observational study in BMJ open gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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17 authors.
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Abstract
objectiveInflammatory bowel disease (IBD) is increasingly diagnosed in older adults, but data from Latin America remain limited. This study aimed to compare the clinical, phenotypic and therapeutic characteristics of elderly and non-elderly adults with IBD in Brazil.
methodsThis cross-sectional study included adults with confirmed Crohn's disease (CD) or ulcerative colitis (UC) attending an IBD clinic in Brazil. Patients were stratified as elderly (≥60 years) or non-elderly (<60 years); elderly individuals were further categorised according to age at diagnosis (<60 years vs ≥60 years). Clinical, therapeutic and frailty-related data were collected from medical records and structured interviews. The primary outcome was biologic therapy use.
results450 patients were included in the study (115 elderly, 335 non-elderly). UC was more common among the elderly patients (77.4% vs 56.7%, p<0.001). Elderly patients had higher comorbidity scores (2.6 vs 0.3 for CD; 2.6 vs 0.4 for UC; p<0.001) and greater polypharmacy (21.7% vs 3.3%, p<0.001) but similar disease activity (CD: Harvey-Bradshaw Index <5, 92.2% vs 79.3%; UC: Mayo Score <2, 88.6% vs 78.3%). They received fewer biologics (26.1% vs 43.6%, p=0.001) and immunosuppressants (22.6% vs 47.5%, p<0.001). Among elderly patients, immunosuppressant use was lower in those diagnosed at ≥60 years (2.9% vs 30.9%, p=0·001). Most elderly patients (82.3%) were robust according to the Clinical Frailty Scale.
conclusionElderly patients were less likely to receive biologic and immunosuppressive therapy despite similar disease activity and had substantially greater comorbidity burden and polypharmacy. These findings suggest that therapeutic decisions in older adults should incorporate frailty and comorbidity assessment to support individualised age-adapted management.
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