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Frailty in Inflammatory Bowel Diseases

炎症性肠病导致的虚弱

基本信息

批准号：
10466974
负责人：
Bharati Kochar
金额：
$ 16.8万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-15 至 2023-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10466974
关键词：
Adult Affect Age Aging American Award Biological Body Weight decreased Caring Chronic Chronic Disease Chronology Code Communities Crohn&apos s disease Data Decision Making Diagnosis Disease Disease Management Disease Progression Disease remission Elderly Elements Encapsulated Enrollment Evaluation Fatigue Foundations Frail Elderly Functional disorder Gait speed Gastrointestinal tract structure Geriatrics Goals Hand Strength Hand functions Health Status Hip Fractures Immunosuppression Incidence Infection Inflammaging Inflammation Inflammatory Inflammatory Bowel Diseases Intervention Life Literature Longitudinal cohort Malignant Neoplasms Measures Morbidity - disease rate Operative Surgical Procedures Osteoporosis Outcome Patient Outcomes Assessments Patients Pharmaceutical Preparations Phenotype Physical Function Physiological Pilot Projects Play Polypharmacy Population Decreases Positioning Attribute Prevalence Process Prospective Studies Prospective cohort Publishing Relapse Research Retrospective Studies Risk Risk Estimate Role Safety Steroids Syndrome Therapeutic immunosuppression Time Training Treatment Efficacy Ulcerative Colitis Work aging population career development clinical care clinical practice cohort demographics design effective therapy end stage liver disease experience falls follow-up frailty functional status grasp high risk improved indexing innovation instrument loss of function mortality older patient outcome prediction patient stratification programs risk stratification sex young adult

项目摘要

PROJECT SUMMARY AND ABSTRACT Inflammatory bowel diseases (IBD), comprised of Crohn’s disease (CD) and ulcerative colitis (UC), are chronic inflammatory conditions of the gastrointestinal (GI) tract affecting over 3 million Americans. IBD is traditionally a disease of the young, but IBD has a bimodal incidence with the second peak occurring in the 7th decade of life. The aging population, decreasing fatality and the rise in incidence and prevalence have led to a prominent increase in older adults with IBD: 26% of Americans with IBD are ≥65 years. IBD patients have geriatric syndromes at earlier ages. Yet the impact of aging-related constructs, such as frailty, on IBD activity and complications are unknown. In retrospective studies, a frailty-related diagnosis code was more prevalent in IBD patients, associated with nearly twice the odds of infections after immunosuppression and nearly triple the odds of mortality. Older adults with IBD have poorer disease and treatment related outcomes compared with younger adults. Frailty constructs have successfully been used to risk stratify patients with cancers and end stage-liver disease. Determining the relationship of frailty with IBD activity and complications is critical to comprehensively assess older adults and risk stratify older patients receiving immunosuppression for IBD treatment. The goal of this proposal is to use the Fried frailty phenotype to characterize frailty in adults ≥60 years with IBD. The aims are to quantify the association between frailty and IBD activity and assess the longitudinal impact of frailty on IBD and treatment-related complications. We have successfully undertaken a pilot study enrolling patients ≥60 years with a confirmed diagnosis of IBD in a cohort designed to study frailty. In this cohort, we will collect demographics, IBD-related information, medications, patient reported outcomes (PROs) as well as disease- specific activity indices. We will assess fatigue, unintentional weight loss and physical function using grip strength, gait speed and a PRO as well administer the vulnerable elders scale (VES). We will repeat these measures 6 and 12 months after a baseline evaluation for longitudinal follow-up. This proposal will be the first prospective study of frailty in older adults with IBD. Positioning a frailty assessment within routine clinical care of IBD patients is pioneering. Characterizing those who are physiologically more fit to withstand immunosuppressive therapies may expand access for effective steroid-sparing, therapies to older adults. For career development, this proposal will facilitate my research in aging-related processes in IBD patients and provide the requisite training to apply principles of geriatrics to IBD. Furthermore, these aims will generate the data needed for a competitive NIA K application to develop a multi-center cohort of older adults with IBD to better understand frailty mechanisms and the utility of a tailored frailty instrument to risk stratify older adults requiring immunosuppression for the treatment of IBD. This path will provide the foundation needed to develop a leading research program with the overarching goal of improving the care of older adults with IBD.

项目总结与摘要

项目成果

期刊论文数量（10）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Pharmacoequity for Older Adults With Inflammatory Bowel Diseases.

患有炎症性肠病的老年人的药效学。

DOI：
10.1016/j.cgh.2023.11.012
发表时间：
2024
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
0
作者：
Kochar,Bharati;Ananthakrishnan,AshwinN;Ritchie,ChristineS
通讯作者：
Ritchie,ChristineS

Oral vs Intravenous Discharge Antibiotic Regimens in the Management of Intra-abdominal Abscesses in Penetrating Crohn's Disease.

口服与静脉排出抗生素治疗穿透性克罗恩病腹内脓肿的治疗方案。

DOI：
10.1093/ibd/izad299
发表时间：
2023
期刊：
Inflammatory bowel diseases
影响因子：
4.9
作者：
Fansiwala,Kush;Rusher,Alison;Shore,Brandon;Herfarth,HansH;Barnes,Edward;Kochar,Bharati;Chang,Shannon
通讯作者：
Chang,Shannon

Current Perspectives on Indications for Ileal Pouch-Anal Anastomosis in Older Patients.

当前对老年患者回肠袋 - 肛门吻合的适应症的看法。