Clinical Characteristics of Late-Onset (≥ 65 Years) Ulcerative Colitis: A Single-Center Retrospective Study

Area of Science:

• Gastroenterology
• Internal Medicine
• Clinical Research

Background:

• Late-onset ulcerative colitis (UC) is increasingly common.
• Differences in clinical presentation and outcomes across UC onset ages remain unclear.

Purpose of the Study:

• To compare clinical characteristics, steroid side effects, remission, and surgical rates in patients with late-onset, middle-aged-onset, and early-onset UC.
• To elucidate the impact of age at diagnosis on UC management and outcomes.

Main Methods:

• Retrospective study of UC patients categorized into three age groups: late-onset (≥65 years), middle-aged-onset (50-64 years), and early-onset (≤49 years).
• Analysis of clinical features, steroid toxicity, remission induction rates, and surgical intervention rates.

Main Results:

• Significant differences observed in clinical characteristics, steroid side effects (more common in late-onset), remission rates (lower in late-onset), and surgery rates (higher in late-onset) across age groups.
• Late-onset UC patients had lower remission rates (67.7%) and higher 12-month (14.2%) and 24-month (23.8%) surgery rates compared to younger groups.

Conclusions:

• Ulcerative colitis outcomes worsen with increasing age at onset, characterized by reduced remission and increased surgical needs.
• Late-onset UC may possess distinct pathogenetic mechanisms, potentially leading to treatment resistance and increased adverse events.