Global Epidemiology and Burden of Elderly-Onset Inflammatory Bowel Disease: A Decade in Review

Abstract

Inflammatory bowel disease (IBD), once thought to impact younger individuals, now manifests in approximately 10% of patients over 65, characterized by a heightened vulnerability to complications and greater diagnostic intricacies than conventional cases. However, comprehensive global epidemiological data regarding elderly-onset IBD are currently insufficient. Our study addresses this critical gap by analyzing trends in elderly-onset IBD over a decade, encompassing the estimation of annual frequencies and age-standardized rates of elderly-onset IBD burden for both genders, stratifying the data by geographical and sociodemographic factors. Our research highlights a notable increase in the proportion of elderly-onset IBD, constituting around 13% of all IBD cases. We observed a rising incidence in males, contrasted by a decreasing trend in females. The highest surge in incidence rates was seen in the Western Pacific region in both genders, but the highest burden was observed in America. Countries with high sociodemographic index (SDI) carried the greatest burden of elderly-onset IBD, while countries with low SDI had the least. The mortality and disability-adjusted life years (DALYs) rates trend downward in most regions. This study underscores an increasing incidence and proportion of IBD, particularly in elderly-onset IBD, particularly in males. While mortality and DALYs are decreasing in most regions, the overall burden remains highest in America and high-SDI countries. Effective public health interventions and comprehensive studies are required to tackle this mounting burden.

Keywords: Crohn’s disease; geriatric; inflammatory bowel disease; ulcerative colitis.

Figure 1

(A) Percentage of elderly-onset IBD compared to overall IBD among males, stratified by World Health Organization region. (B) Percentage of elderly-onset IBD compared to overall IBD among females, stratified by World Health Organization region. Figure legend: IBD: inflammatory bowel disease.

Figure 2

(A) Number of new cases of patients with IBD aged 65–89 in males versus females in 2019, stratified by World Health Organization region. (B) Age-standardized incidence rate of patients with IBD aged 65–89 in males from 2010 to 2019, stratified by World Health Organization region. (C) Age-standardized incidence rate of patients with IBD aged 65–89 in females from 2010 to 2019, stratified by World Health Organization region. (D) Number of deaths of patients with IBD aged 65–89 in males versus females in 2019, stratified by World Health Organization region. (E) Age-standardized death rate of patients with IBD aged 65–89 in males from 2010 to 2019, stratified by World Health Organization region. (F) Age-standardized death rate of patients with IBD aged 65–89 in females from 2010 to 2019, stratified by World Health Organization region. (G) Number of disabilities of patients with IBD aged 65–89 in males versus females in 2019, stratified by World Health Organization region. (H) Age-standardized disability-adjusted life years of patients with IBD aged 65–89 in males from 2010 to 2019, stratified by World Health Organization region. (I) Age-standardized disability-adjusted life years of patients with IBD aged 65–89 in females from 2010 to 2019, stratified by World Health Organization region. Figure legend: ASDALYs: age-standardized disability-adjusted life years; ASDR: age-standardized death rate; ASIR: age-standardized incidence rate.

Figure 3

(A) Age-standardized incidence rate of patients with inflammatory bowel disease aged 65–89 in 2019 in each country. (B) Age-standardized disability-adjusted life year rate of patients with inflammatory bowel disease aged 65–89 in 2019 in each country. Figure legend: ASDALYs: age-standardized disability-adjusted life years; ASIR: age-standardized incidence rate.