P299 Relation of body mass index and health outcomes in elderly patients with inflammatory bowel disease (IBD)

Abstract

Background: Since the global population is aging and inflammatory bowel disease (IBD) has a minimal effect on mortality, the IBD population is aging .Thereby, obesity is a substantial health care problem in the general population, as it is associated with multiple comorbidities. Underweight is a known health risk in IBD patients, but elderly IBD patients may also follow the trend of becoming obese. This study evaluates 1. the prevalence of underweight and obesity, 2. in which way clinical outcome measures are associated with BMI in elderly IBD patients. Finally, dietician consultations are assessed in order to find out whether underweight and obesity are noticed and acted upon by the physician Methods: Consecutive patients aged 65 years and older with IBD were included at the IBD outpatient clinic at the Leiden University Medical Centre. Patients were classified as underweight (BMI< 20 kg/m2), normal weight (20-25 kg/m2), overweight (25-30 kg/m2) or obese ( >30 kg/m2). Additionally, the following parameters were assessed: physical frailty (4-meter walking speed test), cognitive frailty (six item cognitive impairment test (6-CIT)), depression risk (geriatric depression scale (GDS)) and quality of life (QoL) according to the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Moreover, dietician outpatient visits were assessed in the last 5 years. (Table presented) Results: 145 patients were included, of whom 55% had Crohn's disease. The mean age was 71 years. An overview of the results are shown in Table1. Underweight was prevalent in 7% and obesity was found in 14.1%. Underweight was more frequently found in Crohn's disease and obesity in ulcerative colitis. Walking speed was lower in underweight patients compared with the other groups, and QoL was lowest in underweight patients. The 6-CIT did not differ between groups. Risk of depression was highest in the obese-group. More underweight patients visited a dietician than those with a higher BMI. Conclusion(s): Although a substantial part of the elderly IBD patients is underweight, obesity is twice as frequently encountered, of whom most are ulcerative colitis patients. Both underweight and obesity are associated with unfavourable health-outcomes, since underweight is associated with lower quality of life and physical frailty and obesity is associated with a higher depression risk. However, obesity is not recognised by the physician. In conclusion, weight monitoring in IBD outpatients should focus both on underweight and obesity.