Bharati Kochar, MD, on Caring for the Older Adult With IBD

Dr Kochar reviews her talk at AIBD 2023 on how the rapid aging of the population with inflammatory bowel disease will present greater challenges to gastroenterologists when choosing therapies and managing the treatment of patients over 65 with ulcerative colitis or Crohn's disease.

Bharati Kochar, MD, MS, is a gastroenterologist and inflammatory bowel disease specialist at the Massachusetts General Hospital in Boston, Massachusetts.

TRANSCRIPT:

Hello. My name is Bharati Kochar. I'm a gastroenterologist in the Inflammatory Bowel Disease Center at Massachusetts General Hospital in Boston. It was such an honor to deliver a talk on what the gastroenterologist needs to know about caring for the older adult with IBD at the Advances in IBD 2023 conference.

Throughout the conference starting in the very first session, there was a lot of acknowledgment that the patient population with IBD is rapidly aging, especially in the United States and the Western world. So it was great to talk about how do we perhaps differentially care for people who are older. So what I did in the talk to briefly review the epidemiology of older adults with IBD. Then we discussed the known data about the medications that we often use, focusing really on the immunosuppressive agents, in treating older patients with IBD. And then I spent more time discussing a geriatric communication framework, including teach-back consent. We also started a discussion on when to stop surveillance colonoscopies in older patients with IBD.

I discussed other things, such as some preventive care considerations that are unique to older patients and emphasize the importance of care coordination, as older people tend to be more multimorbid or have other providers, and the carers should be very, very coordinated and seamless to the degree possible.

I did end with encouraging the audience to advocate for their older patients with IBD. Older patients tend to get less equitable care for a number of reasons, and I think it's our role as their providers to advocate for them to get as equitable care as they possibly can. I should close by saying that there's no right answers, and the data are very, very sparse. So, really, the talk was, intended to start a conversation and highlight some important questions. It's very hard in this field at this point to have very definitive suggestions and recommendations.