The rising burden of inflammatory bowel disease in East Asia's aging population: A cross-sectional study

East Asia faces a "double challenge" in both aging of population and the increasing incidence of inflammatory bowel disease (IBD). This study aimed to investigate the distribution and temporal trends of older adults with IBD (OA-IBD) in East Asia and explore associated influencing factors. The data (including prevalence, and disability-adjusted life years [DALYs]) of patients with IBD aged ≥60 years for East Asia (including China, Japan, Mongolia, the Republic of Korea, and the Democratic People's Republic of Korea) were extracted from the Global Burden of Disease 2021 database. The joinpoint model was used to analyze the temporal trends of OA-IBD burden. Decomposition analysis was then applied to identify the drivers of the burden of OA-IBD. Additionally, the relationship between OA-IBD burden and the socio-demographic index (SDI) was examined. Between 1990 and 2021, the cases of prevalence of OA-IBD in East Asia increased from 27,167 to 93,572, while DALYs number rose from 59,084 to 95,271. Among the 5 studied countries, the age-standardized prevalence rate showed the most rapid increase in China, whereas Mongolia and the Democratic People's Republic of Korea experienced a decline. During the same period, the age-standardized DALYs rate of OA-IBD decreased significantly across all countries. The decomposition analysis showed that population growth was the primary driver of the increased OA-IBD burden. Furthermore, age-standardized prevalence rate was positively associated with SDI, while age-standardized DALYs rate showed a negative association with SDI. The burden of OA-IBD in East Asia has increased significantly from 1990 to 2021, with notable regional variations.