Biologic treatment decreases dementia risk in senior IBD patients

A retrospective study on inflammatory bowel disease (IBD) in patients aged >65 years revealed that patients with IBD have a higher prevalence of dementia compared with the general population. Interestingly, in those treated with biologics, dementia was significantly less prevalent than in IBD patients not on biologic treatment.

Emerging evidence has identified the so-called gut-brain axis that includes metabolic, endocrine, and neural signalling as communication between the intestine and the central nervous system. Thus, a study point of interest is a possible difference in the prevalence of dementia in those with and without IBD. Healthcare information on over 7.5 million US patients served as a data source to investigate the presence of dementia in older patients with IBD [1].

Between 2016 and 2022, the study included patients who were over 65 years of age, of whom 41,860 had a diagnosis of Crohn’s disease (CD) and 45,530 had ulcerative colitis (UC). These groups equalled 0.55% and 0.60% of the total study cohort. The results showed a significantly higher prevalence of dementia in IBD patients than in the general population (5.4%): CD 10.8% and UC 7.8% (P<0.001 for both comparisons).

Furthermore, the investigators strove to shed light on a possible difference in biologic- and non-biologic-treated IBD patients: 5,450 of the CD and 3,510 of UC patients received biologics. In terms of risk factor distribution in the groups with and without biologics, more than half of the CD and UC patients were women, 69%–88% had hypertension, and 27%–41% had diabetes. A history of smoking was present in 19%–27% of the IBD patients with and without biologic treatment.

Dementia was significantly less frequently found in the biologics group than in those not on biologics. The prevalence in CD was 4.2% with biologics and 11.7% without. The respective results for UC were 4.8% versus 8%, with a P<0.001 for all comparisons.

Dr Ahmed Eltelbany (Cleveland Clinic, OH, USA) and his fellow researchers highlighted that this is the largest individual study investigating prevalence of dementia in senior patients with IBD with and without biological therapy. They concluded that IBD patients over 65 years treated with biologics were significantly less likely to be diagnosed with dementia than those never treated with biologics

1. Eltelbany A, et al. Impact Of Biologics Therapy On The Prevalence Of Dementia Among Older Patients With Inflammatory Bowel Disease: A Nationwide Population-Based Study. Poster Mo1545, Digestive Disease Week 2022, 21–24 May, San Diego, CA, USA.

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Posted on 14 June 20228 April 2024