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

Late-onset ulcerative colitis (UC) has become prevalent in recent years. The differences between late-onset, middle aged-onset, and early-onset UC have not been fully elucidated.

The clinical characteristics, steroid side effects, remission rates, and surgical rates of UC patients were retrospectively studied. Patients were allocated to three groups according to age at diagnosis: late-onset group (≥ 65 years), middle aged-onset (50-64 years), and early-onset group (≤ 49 years).

Clinical characteristics such as admission age, duration of disease, history of cancer, days to diagnosis, clinical activity on admission, hemoglobin level on admission, and steroid use were significantly different between the three groups. The side effects of steroids were significantly more common in the late-onset group. The remission induction rates differed significantly between the three groups: 67.7%, 71.7%, and 83.6% in the late-onset, middle aged-onset, and early-onset groups. Surgery rates were significantly higher in the late-onset group: Surgery rates in the late-onset, middle aged-onset, and early-onset groups were 14.2%, 3.4%, and 3.4% at 12 months of diagnosis, and 23.8%, 10.3%, and 4.2% at 24 months of diagnosis.

In conclusion, remission rates were low and surgical rates were higher with increasing age of onset. In addition, steroid-related side effects increased with age. It was possible that late-onset UC may have a different pathogenesis and be resistant to treatment.