The Bidirectional Relationship Between Cognitive Function and Active Inflammatory Bowel Disease

Area of Science:

• Geriatric Medicine
• Neuroscience
• Gastroenterology

Background:

• Cognitive impairment is a significant geriatric syndrome and a precursor to dementia.
• Inflammatory bowel disease (IBD) affects a growing elderly population.
• Understanding cognitive function in older adults with IBD is crucial for early detection and intervention.

Purpose of the Study:

• To describe cognitive function in adults aged 60 and above diagnosed with IBD.
• To investigate the association between IBD activity and cognitive function.
• To identify potential early screening tools for cognitive decline in IBD patients.

Main Methods:

• A cohort of 356 IBD patients aged ≥60 years was recruited from six US centers.
• Demographics, IBD history, disease activity indices, and the Montreal Cognitive Assessment (MoCA) were collected.
• Multivariate logistic regression models analyzed cognitive function changes and IBD activity over one year.

Main Results:

• At baseline, 42% of participants screened positive for cognitive impairment, with deficits in delayed recall and visuospatial function being most common.
• Within one year, 31% showed improved MoCA scores, while 19% experienced a decline.
• Symptomatically active IBD at baseline significantly predicted worsening cognitive testing at follow-up (aOR: 3.01).

Conclusions:

• Effective management of IBD in older adults is essential to mitigate cognitive decline.
• Deficits in delayed recall, a MoCA sub-domain, are significantly associated with active IBD.
• Delayed recall may serve as a valuable screening tool for cognitive impairment in elderly IBD patients.