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Elderly patients with IBD prone to depression
LAS VEGAS — Depression is common among elderly patients with IBD and can impact both quality of life and medication adherence, according to data presented at the 2012 American College of Gastroenterology Annual Scientific Meeting.
Researchers evaluated 359 patients aged 65 years and older with IBD (mean age, 70.2 years) who completed a 15-question geriatric depression scale (GDS) survey. All participants were collected from an online cohort, founded and structured by Crohn’s and Colitis Foundation of America (CCFA) Partners, of more than 13,000 people with IBD.
The simple clinical colitis activity index (SCCAI) and the short Crohn’s disease activity index (sCDAI) scores measured disease activity, and participants also responded to the short inflammatory bowel disease questionnaire (SIBDQ) regarding quality of life, and were measured on the Morisky medication adherence scale.
Millie D. Long
“Within this cohort, we don’t have as much information about the elderly population,” researcher Millie D. Long, MD, MPH, assistant professor of medicine, gastroenterology and hepatology division at University of North Carolina, Chapel Hill, told Healio.com. “These are people who are excluded from initial clinical trials; we don’t know as much about how they’re treated, with what medications and how they respond, and what their quality of life is.”
Depression was observed in 22.6% of the cohort. Investigators found no associations between depression and age, sex or duration of IBD; they did observe an association with lower education levels (P=.001). Patients with depression were prone to increased disease activity, both among patients with ulcerative colitis (SCCAI score 5 compared with 2 among nondepressed participants, P=.003) and Crohn’s disease (sCDAI score 52.5 compared with 29, P=.005). Quality of life also was lower among depressed participants (SIBDQ score 4.6 vs. 5.7, P<.001).
Patients with depression were less likely to adhere well to medication (P=.01). Researchers noted that this adherence reduction remained after controlling for IBD activity (OR=2.49, 95% CI, 1.26-4.92).
“[Clinicians should] recognize that there is a very high prevalence of depression in the elderly IBD population, and it doesn’t necessarily have the same characteristics of depression [as those] in the general population,” Long said, adding that the study also indicates the GDS is a feasible tool for screening depression in this cohort. “Potentially recognizing this as a component of someone’s medication nonadherence or disease activity [allows for] the possibility that some of these measurements could improve if we could intervene and treat the depression.”
For more information:
Long MD. P965: Risk Factors for Depression in the Elderly Inflammatory Bowel Disease Population. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.