Inflammatory bowel disease in the aging population

As the prevalence of inflammatory bowel disease (IBD) rises rapidly among older adults, gastroenterologists and other health care providers increasingly face challenges in managing age-related comorbidities, polypharmacy, and functional impairments such as frailty and sarcopenia. This narrative review proposes a dual approach to management by optimizing care for patients aged >60 years while promoting the healthy aging of those aged 40-60 years. For patients aged >60 years, we emphasize prescribing effective corticosteroid-sparing medications to control inflammation, conducting medication reconciliations to assess appropriateness and drug interactions, and evaluating baseline hepatic and renal function for necessary dose adjustments. For patients aged 40-60 years, we advise regular screening and nutritional counseling to delay the onset of age-related comorbidities and recommend targeting endoscopic remission to modify the disease course and reduce complications and disability later in life. Given that patients with IBD receiving long-term immunosuppression are at increased risk of infections, adherence to age-appropriate vaccination schedules is also recommended. A proactive and personalized approach to disease management has the potential to optimize quality of life for older adults with IBD.