Octa-nonagenarians can perform video capsule endoscopy safely and with a higher diagnostic yield than 65-79-year-old patients

J Am Geriatr Soc. 2022 Oct;70(10):2958-2966. doi: 10.1111/jgs.17953. Epub 2022 Jul 5.


Background: Video capsule endoscopy (VCE) is an effective, noninvasive modality for small bowel (SB) investigation. Its usage in the older adults is rising. However, data in octa-nonagenarians regarding diagnostic yield and motility are lacking. Our aim was to evaluate and compare safety and efficacy of VCE between age subgroups of older adult patients.

Methods: This was a retrospective study of prospectively documented data. All consecutive VCEs of patients ≥65 years (01/2010-12/2017) were included. Patients unable to swallow the capsule or videos with significant recording technical malfunction were excluded. The cohort was divided into the younger group aged 65-79 years old and octa-nonagenarians aged ≥80 years old. Indications for referral, diagnostic yield and transit times were compared between groups.

Results: A total of 535 VCEs were performed in 499 older adult patients (51.2% males); 82.8% were 65-79 years old and 17.2% were ≥80 years old. The ≥80-year-old group had higher rates of clinically significant findings (52.7% vs. 40.0%, p = 0.025), active bleeding (12.5% vs. 6.5%, p = 0.053) and angioectasia (36.0% vs. 23.4%, p = 0.014). Crohn's disease was newly diagnosed in approximately 8% of the entire cohort and 12% of the ≥80 years old. Anemia was the most common indication in both groups, followed by overt bleeding in the ≥80-year-old group (25% vs. 9.9% in 65-79-year-old group, p < 0.001) and Crohn's disease in the 65-79 years old (17.2% vs. 5.4% in ≥80 years old, p = 0.004). Groups were comparable in transit time and cecal documentation rates.

Conclusions: In octa-nonagenarians, VCE is as safe as in younger older-adults with a higher diagnostic yield of significant and treatable conditions.

Keywords: Crohn's disease; anemia; capsule endoscopy; gastrointestinal bleeding; older adults.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Capsule Endoscopy*
  • Crohn Disease* / diagnosis
  • Female
  • Gastrointestinal Hemorrhage / diagnosis
  • Humans
  • Intestine, Small
  • Male
  • Nonagenarians
  • Retrospective Studies