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P145. Clinical and phenotypic characteristics of Crohn's disease in elderly people: A population-based study

C. Charpentier1, J. Salleron2, G. Savoye3, L. Dauchet2, V. Merle4, J.‑L. Dupas5, A. Cortot6, L. Peyrin-Biroulet7, E. Lerebours8, C. Gower-Rousseau9, J.‑F. Colombel10

1Rouen University and Hospital, Gastroenterology, Rouen, France; 2Lille University Hospital, Epidemiology Unit, Lille, France; 3Hôpital Charles Nicolle, Department of Gastroenterology, Rouen, France; 4Hospital and University, Rouen, France; 5Amiens University Hospital North Hospital, Dept. of Hepagastroenterology, Amiens, France; 6Lille University Hospital, Lille, France; 7University Hospital of Nancy, Hepato-Gastroenterology, Vandoeuvre-Lès-Nancy, France; 8Hôpital Charles Nicolle, Rouen, France; 9Lille University Hospital, Epidemiology Unit, EPIMAD Registry, Lille, France; 10Centre Hospitalier Universitaire de Lille, Hôpital Claude Huriez, Lille, France

Background: The clinical characteristics of Crohn's disease (CD) in elderly people remain poorly documented. The aim of this study was to compare, in a population-based level, the clinical and phenotypic characteristics of CD at diagnosis in two cohorts of patients: patients between 20–40 years and patients older than 60 years.

Methods: Two cohorts of patients with definite or probable CD [1] were identified from the EPIMAD Registry, a population database that prospectively recruited patients diagnosed with IBD between 1988 and 2010.

At CD diagnosis20–40 y (N = 4626)>60 y (N = 513)p
% patients with CD vs UC6344<10−5
% patients with CCD incidence (/105) [95% CI] D vs UC12.3 [12.0–12.7]2.4 [2.1–2.7]<10−6
Family history of IBD (%)147<10−4
Rectal bleeding341<10−3
Anal fistula36=10−3
Extra intestinal manif (%)812<10−2
L2/L3 disease (%/%)13/4631/23<10−4
B2/B3 disease (%/%)30/419/13<10−2

Results: 5139 patients were included for analysis, of whom 513 were older than 60 y at CD diagnosis. Gender distribution was similar between groups. Time from symptoms-to-diagnosis (mos) was significantly lower in older group than in 20–40 yrs group (2 vs 3; p < 10–4). The clinical and phenotypic characteristics of the study groups at CD diagnosis are presented in the table.

Conclusions: CD is infrequent in patients >60 years. In this age range, it is characterized by a higher frequency of colonic location, extra-intestinal manifestations, penetrating behavior and perianal disease at diagnosis, as compared to a younger population.

1. Gower-Rousseau C (1994), Incidence of inflammatory bowel disease in northern France (1988–1990). Gut.