Frailty Screening is Associated with Hospitalization and Decline in Quality of Life and Functional Status in Older Patients with Inflammatory Bowel Disease
V Asscher, Mar Rodríguez Girondo, Jesse Fens, S Waars, Rogier J. L. Stuyt, A. Martine C. Baven-Pronk, Nidhi Srivastava, Rutger J. Jacobs, J Haans, Lennart J. Meijer, Jacqueline D. Klijnsma-Slagboom, Marijn H. Duin, Milou E.R. Peters, Victor Kong, Nanda E. Provoost, Femke Tijdeman, Kenan T. van Dijk, Monse W. M. Wieland, Mirre G.M. Verstegen, Melissa E. van der Meijs, Annemijn D.I. Maan, Floor J. van Deudekom, Andrea E. van der Meulen‐de Jong, Simon P. Mooijaart, Jeroen Maljaars
Abstract
BACKGROUND AND AIMS: Our goals were to study frailty screening in association with hospitalization and decline in quality of life [QoL] and functional status in older patients with inflammatory bowel diseases [IBD]. METHODS: This was a prospective multicentre cohort study in IBD patients ≥65 years old using frailty screening [G8 Questionnaire]. Outcomes were all-cause, acute, and IBD-related hospitalization, any infection, any malignancy, QoL [EQ5D-3L], and functional decline (Instrumental Activities of Daily Living [IADL]) during 18 months of follow-up. Confounders were age, IBD type, biochemical disease activity [C-reactive protein ≥10 mg/L and/or faecal calprotectin ≥250 µg/g], and comorbidity [Charlson Comorbidity Index]. RESULTS: Of 405 patients, with a median age of 70 years, 196 [48%] were screened as being at risk for frailty. All-cause hospitalizations occurred 136 times in 96 patients [23.7%], and acute hospitalizations 103 times in 74 patients [18.3%]. Risk of frailty was not associated with all-cause (adjusted hazard ratio [aHR] 1.5, 95% confidence interval [CI] 0.9-2.4), but was associated with acute hospitalizations [aHR 2.2, 95% CI 1.3-3.8]. Infections occurred in 86 patients [21.2%] and these were not associated with frailty. A decline in QoL was experienced by 108 [30.6%] patients, and a decline in functional status by 46 patients [13.3%]. Frailty screening was associated with a decline in QoL (adjusted odds ratio [aOR] 2.1, 95% CI 1.3-3.6) and functional status [aOR 3.7, 95% CI 1.7-8.1]. CONCLUSIONS: Frailty screening is associated with worse health outcomes in older patients with IBD. Further studies are needed to assess the feasibility and effectiveness of its implementation in routine care.