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Crohn's disease in the elderly

P A Shapiro, M A Peppercorn, D A Antoniolo

The American Journal of Gastroenterology

|August 1, 1981

Summary

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Crohn

Area of Science:

Gastroenterology
Internal Medicine
Geriatric Medicine

Background:

Crohn's disease (CD) diagnosis in elderly patients presents unique challenges.
Understanding CD features in older adults is crucial for effective management.

Purpose of the Study:

To delineate the clinical, radiographic, and histologic characteristics of Crohn's disease in patients aged 60 and above.
To compare CD presentation in elderly versus younger populations.

Main Methods:

Retrospective chart, roentgenogram, and pathology review of elderly Crohn's disease patients (onset >60 years) diagnosed between 1966-1979.
Analysis of disease location (ileitis, colitis, ileocolitis), surgical requirements, and recurrence rates.

Main Results:

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Thirty-three elderly patients (5.2% of total CD cases) were identified.
Clinical, radiographic, and histologic features were largely similar to younger patients.
Differentiation from ischemic bowel disease and diverticulitis was challenging, often requiring histology.
Surgery was required in 58% of elderly patients, with higher rates in colitis (91%) and ileocolitis (50%).
Cumulative clinical recurrence rate for ileal disease was 21% at 9 years and 37% at 15 years.

Conclusions:

Crohn's disease in the elderly shares many features with younger patients but poses diagnostic difficulties.
Elderly patients, particularly those with colitis, have a high rate of surgical intervention.
Long-term recurrence rates in elderly patients with ileal Crohn's disease are significant.