Document Detail


Crohn's disease in the over-60 age group: a population based study.
MedLine Citation:
PMID:  15201578     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Late-onset Crohn's disease (CD) may show a distinctive pattern of expression. The aim of our study was to describe the incidence or presentation of CD in the elderly and compare the outcomes in patients < 60 years or > or = 60 years at diagnosis. METHODS: The study included a population based inception cohort of all incident CD cases diagnosed in Brittany (France) between 1994 and 1997. Sixty-three patients were > or = 60 years and 201 were < 60 years at diagnosis. The physicians managing the patients used standardized questionnaires to collect the study data. The questionnaires on outcomes and treatments were completed in 2002. RESULTS: In patients > or = 60 years, the annual incidence was 2.5 per 10 persons and clinical features were similar to those in younger patients, except for a higher rate of colon involvement. Among older patients, those with diverticula (29/63, 46%) were more likely to have granulomas (58% vs 33% of patients without diverticula, P < 0.04), but the diagnosis of CD was confirmed by lesions remote from the diverticula in most cases (23/29). Early resection rates were not higher in older patients, who were less likely to require immunosuppressants or re-admission for CD flares, as compared to younger patients. Five year mortality in older patients was 16% but was unrelated to CD. CONCLUSIONS: In Brittany, the age specific incidence, clinical features, and prognosis of CD among the elderly are comparable to those in younger individuals. Colon involvement is more common. Concomitant diverticular disease is common and should prompt a search for CD lesions at other sites to confirm the diagnosis. Older patients are less likely to require immunosuppressants or admission for flares.
Authors:
Denis Heresbach; Jean-Luc Alexandre; Jean-François Bretagne; Etienne Cruchant; Alain Dabadie; Michèle Dartois-Hoguin; Pierre-Marie Girardot; Hervé Jouanolle; Jean Kerneis; Jean-Claude Le Verger; Véronnique Louvain; Lena Pennognon; Martial Richecoeur; Joseph Politis; Michel Robaszkiewicz; Jacques Arnaud Seyrig; Isabelle Tron;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  16     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-17     Completed Date:  2005-03-17     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  657-64     Citation Subset:  IM    
Affiliation:
Service des Maladies de l'Appareil Digestif, Hôpital Pontchillou, Rennes, France. denis.heresbach@chu-rennes.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Age of Onset
Aged
Aged, 80 and over
Crohn Disease / complications,  epidemiology*,  pathology,  therapy
Diverticulum / complications
Female
France / epidemiology
Gastrointestinal Agents / administration & dosage
Granuloma / complications
Humans
Incidence
Intestinal Diseases / complications
Male
Patient Readmission / statistics & numerical data
Prognosis
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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