Avaliação da qualidade de vida em pacientes idosos portadores de doenças inflamatórias intestinais em atividade leve ou remissão

Abstract

Inflammatory bowel disease (IBD), represented by Crohn's disease (CD) and ulcerative colitis (UC) is a chronic and progressive condition that affects all age groups, although it predominates in young individuals. Currently, an increase in the prevalence of IBD has been documented, in parallel with the increase in the elderly population. The scarce number of studies that better characterize the impact of IBD on Quality of Life (QoL) in the elderly motivated the present study. In this study, the impact of IBD on the QoL of elderly people treated at a Tertiary IBD Center was evaluated. This is a prospective cross-sectional study that included elderly patients (≥ 60 years old) with IBD, treated at the HU/UFJF IBD Center, between March 2019 and December 2022, and who presented clinical remission or mild disease activity. Companions of elderly people without serious comorbidities who attended consultations with the patients were included as a control group. Sociodemographic and IBD-related characteristics were recorded. QoL was assessed using previously validated questionnaires (WHOQOL-bref and IBDQ). Patients with IBD in moderate to severe activity, history of recent or imminent hospitalization, serious or opportunistic infections in the last six months, previous neoplasia, dementia, difficulty understanding/completing the questionnaires were excluded. 123 patients were included (74 with IBD and 49 in the control group), with a mean age of 67  6.2 years, 52.7% with CD and 47.3% with UC. Mild disease activity was observed in 31.1%. Both groups (IBD patients and control) were comparable based on age, sex, Body Mass Index and Charlson Comorbidity Index. Patients with IBD and controls had similar QoL scores in the different domains assessed by the WHOQOL-bref. On the other hand, when evaluating the general facet of QoL, patients with IBD had significantly lower scores in general QoL (3.71  0.87  4.02  0.62, respectively; p = 0.021) and in General Health ( 3.32  1.05  3.69  0.94, respectively; The presence of light activity had a negative impact on the general health and physical domain scores of the WHOQOL-bref when compared to patients in remission (2.91  0.99  3.47  1.04, respectively; p = 0.035 and 12.27  2.63  13.86  2.61, respectively; No impact on QoL was observed with the application of the IBDQ questionnaire regarding the type of IBD (161  38.5  163.1 ± 42.6 for CD and UC, respectively; p = 0.84) or the presence of activity (152.5  38.8  166.4  40.5, respectively; p = 0.17). No statistically significant differences were found between elderly patients with IBD in mild or quiescent activity and elderly patients without IBD when observing global QoL scores. However, IBD negatively impacted the general facet of QoL, just as the presence of light activity was associated with lower scores in general health and in the physical domain assessed by the WHOQOL-bref. Future studies are needed to choose the most appropriate tool for assessing QoL in this population.