Older Adults with Inflammatory Bowel Disease Epidemiology in the United States: 2000-2021

Abstract

Background: As the United States population ages, the incidence and prevalence of inflammatory bowel disease (IBD) among older adults are on the rise.

Aims: This study provides updated estimates of the IBD burden in older adults and examines changes from 2000 to 2021.

Methods: We analyzed data on IBD incidence, prevalence, and disability-adjusted life years (DALYs) in older adults (> 70 years) in the United States from the Global Burden of Disease Study 2021, stratified by sex and state. Using the Joinpoint regression model, we evaluated age-standardized rate changes from 2000 to 2021.

Results: The study estimated 11,250 new cases, 180,880 prevalent cases, and 80,410 DALYs from IBD in older adults in the United States in 2021. In 2021, older adults-onset represented 15% of the total IBD population in the United States, a 3% increase since 2000. Between 2000 and 2021, the incidence (Annual percent change [APC]: 0.58%, 95%CI 0.50 to 0.66%) and DALYs rates (APC: 0.34%, 95%CI 0.07 to 0.62%) increased, while the prevalence rates remained stable. Incidence rate increased at a higher extent in older adults-onset IBD in females compared to that of males. Forty-seven states experienced increased older adults-onset IBD incidence rates during this period.

Conclusion: From 2000 to 2021, the incidence and disability rates of older adults-onset IBD increased in the United States. Although older males initially had higher incidence rates, the rates have disproportionately increased among older females. The proportion of older adults-onset IBD cases and related disability has also grown, highlighting the urgent need for strategies to address the rising IBD burden in older adults.

Keywords: Crohn’s disease; Disparity; Geriatrics; Inflammatory bowel disease; Ulcerative colitis.