Inflammatory bowel disease (IBD) constitutes a spectrum of disorders characterised by chronic inflammation of the gastrointestinal tract, primarily encompassing Crohn’s Disease (CD), Ulcerative Colitis (UC), and IBD-unclassified (IBD-U). Epidemiological data indicate that the global prevalence of IBD exceeds 6.8 million individuals, posing substantial personal and public health burdens. Diagnosis age is a critical determinant of IBD progression and outcomes, with elderly-onset IBD (diagnosis !60 years) constituting 10-20% of incident cases.
Current evidence remains conflicted regarding prognosis in elderly-onset IBD: A Korean study reported better outcomes for patients diagnosed after age 40, manifested by higher remission rates, lower surgical requirements, and significantly reduced use of biologics such as immunomodulators and TNF-! antagonists during follow-up. However, a meta-analysis indicates that although elderly IBD patients exhibit lower rates of extraintestinal manifestations and certain complications, their surgical rates are comparable to or potentially higher than those in non-elderly populations.
The genetic mechanisms underlying clinical heterogeneity between early- and elderly-onset IBD are incompletely understood. This project will leverage UK Biobank data to establish an integrated risk stratification framework addressing age-specific IBD pathogenesis. Core objectives are: (1) Determine whether genetic susceptibility loci exert age-stratified effects on IBD development via genome-wide association studies comparing elderly-onset and early-onset cohorts; (2) Develop a multi-modal risk model integrating genomic, immunological, and microbial biomarkers.
