The 2023 Impact of Inflammatory Bowel Disease in Canada: Special Populations-IBD in Seniors

Seth R Shaffer^{1

2}, M Ellen Kuenzig^{3

4}, Joseph W Windsor⁵, Alain Bitton⁶, Jennifer L Jones⁷, Kate Lee⁸, Sanjay K Murthy^{9

10}, Laura E Targownik¹¹, Juan-Nicolás Peña-Sánchez¹², Noelle Rohatinsky¹³, Sara Ghandeharian⁸, Parul Tandon¹⁴, Joëlle St-Pierre⁵, Navneet Natt¹⁵, Tal Davis^{3

4}, Jake Weinstein^{3

4}, James H B Im^{3

4}, Eric I Benchimol^{3

4

16

17

18}, Gilaad G Kaplan⁵, Quinn Goddard⁵, Julia Gorospe⁵, Maxime Bergevin^{19

20}, Ken Silver⁸, Dawna Bowles⁸, Margaret Stewart⁸, Marsha Pearlstein⁸, Elizabeth H Dawson⁸, Charles N Bernstein^{1

2}

Affiliations

¹ Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
² University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada.
³ SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁴ Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁵ Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
⁶ Division of Gastroenterology and Hepatology, McGill University Health Centre IBD Centre, McGill University, Montréal, Quebec, Canada.
⁷ Departments of Medicine, Clinical Health, and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
⁸ Crohn's and Colitis Canada, Toronto, Ontario, Canada.
⁹ Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁰ The Ottawa Hospital IBD Centre, Ottawa, Ontario, Canada.
¹¹ Division of Gastroenterology and Hepatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
¹² Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹³ College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹⁴ Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
¹⁵ Northern Ontario School of Medicine University, Sudbury, Ontario, Canada.
¹⁶ ICES, Toronto, Ontario, Canada.
¹⁷ Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁸ Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
¹⁹ École de kinésiologie et des sciences de l'activité physique, Faculté de médecine, Université́ de Montréal, Montreal, Quebec, Canada.
²⁰ Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada.

PMID: 37674503
PMCID: PMC10478801
DOI: 10.1093/jcag/gwad013

Review

The 2023 Impact of Inflammatory Bowel Disease in Canada: Special Populations-IBD in Seniors

Seth R Shaffer et al. J Can Assoc Gastroenterol. 2023.

. 2023 Sep 5;6(Suppl 2):S45-S54.

doi: 10.1093/jcag/gwad013. eCollection 2023 Sep.

Authors

Affiliations

¹ Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
² University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada.
³ SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁴ Child Health Evaluative Sciences, SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁵ Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
⁶ Division of Gastroenterology and Hepatology, McGill University Health Centre IBD Centre, McGill University, Montréal, Quebec, Canada.
⁷ Departments of Medicine, Clinical Health, and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
⁸ Crohn's and Colitis Canada, Toronto, Ontario, Canada.
⁹ Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁰ The Ottawa Hospital IBD Centre, Ottawa, Ontario, Canada.
¹¹ Division of Gastroenterology and Hepatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
¹² Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹³ College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
¹⁴ Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
¹⁵ Northern Ontario School of Medicine University, Sudbury, Ontario, Canada.
¹⁶ ICES, Toronto, Ontario, Canada.
¹⁷ Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁸ Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
¹⁹ École de kinésiologie et des sciences de l'activité physique, Faculté de médecine, Université́ de Montréal, Montreal, Quebec, Canada.
²⁰ Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada.

PMID: 37674503
PMCID: PMC10478801
DOI: 10.1093/jcag/gwad013

Abstract

Approximately one out of every 88 seniors has inflammatory bowel disease (IBD), and this is expected to increase in the future. They are more likely to have left-sided disease in ulcerative colitis, and isolated colonic disease in Crohn's disease; perianal disease is less common. Other common diagnoses in the elderly must also be considered when they initially present to a healthcare provider. Treatment of the elderly is similar to younger persons with IBD, though considerations of the increased risk of infections and malignancy must be considered when using immune modulating drugs. Whether anti-TNF therapies increase the risk of infections is not definitive, though newer biologics, including vedolizumab and ustekinumab, are thought to be safer with lower risk of adverse events. Polypharmacy and frailty are other considerations in the elderly when choosing a treatment, as frailty is associated with worse outcomes. Costs for IBD-related hospitalizations are higher in the elderly compared with younger persons. When elderly persons with IBD are cared for by a gastroenterologist, their outcomes tend to be better. However, as elderly persons with IBD continue to age, they may not have access to the same care as younger people with IBD due to deficiencies in their ability to use or access technology.

Keywords: Comorbidity; Crohn’s disease; Elderly; Risks; Ulcerative colitis.

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Conflict of interest statement

Seth Shaffer has served on advisory boards or consulted with Takeda Canada, AbbVie Canada, Janssen Canada, and Pfizer Canada. Ellen Kuenzig is a member of the Scientific and Medical Advisory Council of Crohn’s and Colitis Canada. Alain Bitton has participated in advisory boards with AbbVie, Janssen, Takeda, McKesson, BioJamp, Bristol Myers Squibb Hoffman-LaRoche, Amgen. He has received research support from AbbVie. He is on the speaker’s panel for Janssen, Takeda, AbbVie and has participated in educational activities supported by Viatris, has received educational support from Fresenius Kabi, Amgen, and Takeda. Jennifer Jones has received honoraria for speaking and consulting for AbbVie, Janssen, Pfizer, Shire, and Takeda. She is the co-chair of the Scientific and Medical Advisory Council of Crohn’s and Colitis Canada. Kate Lee has received honoraria from AbbVie Corporation and Bristol Myers Squibb Canada. Sanjay Murthy haspreviously participated in advisory board meetings for AbbVie, Janssen, Takeda, Pfizer, Shire and Ferring and as a speaker at educational events sponsored by Janssen, AbbVie and Pfizer. Laura Targownik has received research funding from AbbVie Canada, Takeda Canada, Sandoz Canada, Amgen Canada, Gilead Canada, Roche Canada and Pfizer Canada, and has been on Advisory Boards for Janssen Canada, AbbVie Canada, Takeda Canada, Pfizer Canada, Merck Canada, Roche Canada, Sandoz Canada, Organon Canada, Fresesnius Kabi Canada, Eli Lilly Canada, and Amgen Canada. She is a member of the Scientific and Medical Advisory Council of Crohn’s and Colitis Canada. Eric Benchimol holds the Northbridge Financial Corporation Chair in Inflammatory Bowel Disease, a joint Hospital-University Chair between the University of Toronto, The Hospital for Sick Children, and the SickKids Foundation. He has acted as a consultant for the Dairy Farmers of Ontario and McKesson Canada for matters unrelated to medications used to treat inflammatory bowel disease. He is Past Chair of the Scientific and Medical Advisory Council of Crohn’s and Colitis Canada and Editor-in-Chief of the Journal of the Canadian Association of Gastroenterology (JCAG). Gilaad Kaplan has received honoraria for speaking or consultancy from AbbVie, Janssen, Pfizer, and Takeda. He has received research support from Ferring, Janssen, AbbVie, GlaxoSmith Kline, Merck, and Shire. He has been a consultant for Gilead. He shares ownership of a patent: TREATMENT OF INFLAMMATORY DISORDERS, AUTOIMMUNE DISEASE, AND PBC. UTI Limited Partnership, assignee. Patent WO2019046959A1. PCT/CA2018/051098. 7 Sept. 2018. He is a member of the Scientific and Medical Advisory Council of Crohn’s and Colitis Canada. Charles Bernstein is supported in part by the Bingham Chair in Gastroenterology. He is on Advisory Boards for AbbVie Canada, Amgen Canada, Bristol Myers Squibb, JAMP Pharmaceuticals, Lilly Canada, Janssen Canada, Pfizer Canada, Roche Canada, Sandoz Canada, Takeda Canada. He is a Consultant for Mylan Pharmaceuticals and Takeda. He has received educational grants from AbbVie Canada, Pfizer Canada, Takeda Canada, Janssen Canada, and Bristol Myers Squibb Canada. He is on the speaker’s panel for AbbVie Canada, Janssen Canada, Pfizer Canada, and Takeda Canada. Received research funding from AbbVie Canada, Amgen Canada, Pfizer Canada, Sandoz Canada. None: Joseph Windsor, Juan-Nicolás Peña-Sánchez, Noelle Rohatinsky, Sara Ghandeharian, Parul Tandon, Joëlle St-Pierre, Navneet Natt, Tal Davis, Jake Weinstein, James Im, Quinn Goddard, Julia Gorospe, Maxime Bergevin, Ken Silver, Dawna Bowles, Margaret Stewart, Marsha Pearlstein, Elizabeth Dawson.

References

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The 2023 Impact of Inflammatory Bowel Disease in Canada: Special Populations-IBD in Seniors

Affiliations

The 2023 Impact of Inflammatory Bowel Disease in Canada: Special Populations-IBD in Seniors

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

LinkOut - more resources

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