GETECCU position paper on fragility, advanced age and inflammatory bowel disease

Abstract

Frailty is a state of vulnerability characterised by a decrease in physiological reserve and the ability to respond to stress, which increases the risk of complications, adverse effects of treatments and functional decline. Assessing frailty allows the biological age of patients to be determined, beyond their chronological age, providing a more accurate picture of their health status and care needs. The proportion of older adults with IBD is increasing in parallel with the ageing of the general population, and it is estimated that in the next decade, more than a third of IBD patients will be over 60 years of age. This population may suffer from complications arising from previously developed IBD and is particularly susceptible to developing side effects from treatment, making comprehensive assessment essential in order to identify those who are most vulnerable. Frailty is compounded by other geriatric syndromes such as comorbidity and polypharmacy, which can significantly interfere with the management and course of IBD, influencing the therapeutic strategy and prognosis. OBJECTIVE: In this context, comprehensive geriatric assessment should be systematic in elderly patients with IBD, with the aim of detecting functional deficits and implementing specific interventions for nutritional support, functional rehabilitation and psychological care to optimise their progress. This position paper aims to establish recommendations in this regard based on the available evidence. CONCLUSIONS: The systematic incorporation of comprehensive geriatric assessment in the management of older people with IBD represents an essential strategy for improving clinical outcomes, adapting treatments to the patient's functional capacity and promoting a truly person-centred approach.

Keywords: Colitis ulcerosa; Crohn's disease; Elderly; Enfermedad de Crohn; Enfermedad inflamatoria intestinal; Fragilidad; Frailty; Inflammatory bowel disease; Ulcerative colitis; edad avanzada.