{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:47:11Z","timestamp":1785822431920,"version":"3.56.0"},"reference-count":103,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005888","name":"Uniwersytet Medyczny w Lodzi","doi-asserted-by":"publisher","award":["503\/1-002-01\/503-11-001"],"award-info":[{"award-number":["503\/1-002-01\/503-11-001"]}],"id":[{"id":"10.13039\/501100005888","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging"],"abstract":"<jats:p>\n                    Ulcerative colitis (UC) demonstrates a bimodal incidence distribution, with a significant second peak and the highest prevalence observed in individuals aged \u226560 years. The pathogenesis of elderly UC involves immunosenescence\u2014manifested by Th17\/Treg imbalance and the accumulation of cells with a pro-inflammatory senescence-associated secretory phenotype (SASP)\u2014alongside age-related dysbiosis, increased intestinal permeability, and mitochondrial dysfunction that impairs mucosal regeneration. Clinically, older patients more frequently present with left-sided colitis, characterized by anemia and weight loss, while abdominal pain is less common. Managing geriatric UC is challenging due to inadequate colonoscopy preparation and complex differential diagnosis (e.g., colorectal cancer, ischemic colitis). Furthermore, older adults face a fivefold increased risk of\n                    <jats:italic>Clostridioides difficile<\/jats:italic>\n                    infection and a sharply rising risk of colorectal cancer if diagnosed after 70 years of age. While 5-aminosalicylic acid remains the first-line therapy, it requires renal monitoring. Conversely, steroids increase infection and osteoporosis risks, thiopurines are restricted due to myelotoxicity and malignancy risks, and among biologics, vedolizumab offers better safety than anti-TNF agents. Ultimately, managing UC in older adults requires a comprehensive, multidisciplinary approach that accounts for multimorbidity, polypharmacy, nutritional status, and mental health to optimize pharmacotherapy and mitigate high-risk surgical interventions.\n                  <\/jats:p>","DOI":"10.3389\/fragi.2026.1815043","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:36:18Z","timestamp":1785821778000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ulcerative colitis (UC) in the elderly: diagnostic and therapeutic considerations"],"prefix":"10.3389","volume":"7","author":[{"given":"\u0141ucja","family":"Wr\u00f3bel","sequence":"first","affiliation":[{"name":"Department of Digestive Tract Diseases, Medical University of Lodz","place":["Lodz, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Ma\u0142ecka-Wojciesko","sequence":"additional","affiliation":[{"name":"Department of Digestive Tract Diseases, Medical University of Lodz","place":["Lodz, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2066","DOI":"10.1056\/NEJMra0804647","article-title":"Inflammatory bowel disease","volume":"361","author":"Abraham","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/j.amjmed.2009.01.022","article-title":"Osteoporosis in inflammatory bowel disease","volume":"122","author":"Ali","year":"2009","journal-title":"Am. J. Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"661","DOI":"10.15537\/smj.2023.44.7.20220916","article-title":"Outcomes of emergency colorectal surgery in elderly population","volume":"44","author":"Alselaim","year":"2023","journal-title":"Saudi Med. J."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1545","DOI":"10.1053\/j.gastro.2020.08.060","article-title":"Management of inflammatory bowel disease in elderly patients: a clinical practice update by the American Gastroenterological Association","volume":"159","author":"Ananthakrishnan","year":"2020","journal-title":"Gastroenterol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2746","DOI":"10.1093\/ibd\/izaf063","article-title":"Incidence of osteoporosis and osteopenia in newly diagnosed inflammatory bowel disease: a Population- based cohort study","volume":"31","author":"Attauabi","year":"2025","journal-title":"Inflamm. Bowel Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1097\/MCG.0000000000001557","article-title":"Older adult patients use more aminosalicylate monotherapy compared with younger patients with inflammatory bowel disease: TARGET-IBD","volume":"56","author":"Barnes","year":"2022","journal-title":"J. Clin. Gastroenterol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1001\/archsurg.2009.114","article-title":"Identification of specific quality improvement opportunities for the elderly undergoing gastrointestinal surgery","volume":"144","author":"Bentrem","year":"2009","journal-title":"Arch. Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.clnu.2022.12.004","article-title":"ESPEN guideline on clinical nutrition in inflammatory bowel disease","volume":"42","author":"Bischoff","year":"2023","journal-title":"Clin. Nutr."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1736","DOI":"10.1016\/j.cgh.2018.12.032","article-title":"Safety of biologic therapy in older patients with immune-mediated diseases: a systematic review and meta-analysis","volume":"17","author":"Borren","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1093\/ecco-jcc\/jjad183","article-title":"Differences in management and outcomes of older and younger adults with acute severe ulcerative colitis","volume":"18","author":"Boyd","year":"2024","journal-title":"J. Crohn's Colitis"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1795","DOI":"10.1038\/ajg.2014.313","article-title":"Oral corticosteroids and the risk of serious infections in patieavailable elderly-onset inflammatory bowel diseases","volume":"109","author":"Brassard","year":"2014","journal-title":"Am. J. Gastroenterology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1093\/ecco-jcc\/jjae067","article-title":"Considerations on multimorbidity and frailty in inflammatory bowel diseases","volume":"18","author":"Carbery","year":"2024","journal-title":"J. Crohns Colitis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.31857\/S0026898423060058","article-title":"Role of mitochondria in intestinal epithelial barrier dysfunction in inflammatory bowel disease","volume":"57","author":"Chernyavskij","year":"2023","journal-title":"Mol. Biol. Mosk."},{"key":"B15","doi-asserted-by":"publisher","first-page":"S115","DOI":"10.14309\/01.ajg.0001129604.14865.84","article-title":"S536Bowel preparation quality in elderly vs younger adults: implications for colorectal cancer screening","volume":"120","author":"Chinthala","year":"2025","journal-title":"Am. J. Gastroenterology"},{"key":"B16","first-page":"2624","article-title":"Loss of phagocytic and antigen cross presenting capacity in aging dendritic cells Is associated with mitochondrial dysfunction","volume-title":"J. Immun.","author":"Chougnet","year":"2015"},{"key":"B17","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1007\/s11894-023-00874-9","article-title":"Indications and safety of newer IBD treatments in the older patient","volume":"25","author":"Clement","year":"2023","journal-title":"Curr. Gastroenterol. Rep."},{"key":"B18","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.cgh.2010.09.026","article-title":"Advanced age is an independent risk factor for severe infections and mortality in patients given anti-tumor necrosis factor therapy for inflammatory bowel disease","volume":"9","author":"Cottone","year":"2011","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"9458","DOI":"10.3748\/wjg.v20.i28.9458","article-title":"Epidemiology, demographic characteristics and prognostic predictors of ulcerative colitis","volume":"20","author":"da Silva","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1097\/MOG.0000000000000739","article-title":"Diagnosis and management of Clostridioides difficile infection in patients with inflammatory bowel disease","volume":"37","author":"Dalal","year":"2021","journal-title":"Curr. Opin. Gastroenterol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"835","DOI":"10.3390\/gastroent15030059","article-title":"Therapeutic needs of older adults with Inflammatory Bowel Disease (IBD): a systematic review","volume":"15","author":"Davis","year":"2024","journal-title":"Gastroenterol. Insights"},{"key":"B24","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1093\/ecco-jcc\/jju009","article-title":"The European Crohn\u2019s and Colitis Organisation [ECCO], European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases","volume":"9","author":"Dignass","year":"2015","journal-title":"J. Crohn's Colitis"},{"key":"B25","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s13690-024-01392-4","article-title":"Analysis of factors affecting the length of hospitalization of patients with Clostridioides difficile infection: a cross-sectional study","volume":"82","author":"Drobnik","year":"2024","journal-title":"Arch. Public Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.3390\/nu11061421","article-title":"Dietary support in elderly patients with inflammatory bowel disease","volume":"11","author":"Eder","year":"2019","journal-title":"Nutrients"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5114\/pg.2023.125882","article-title":"Guidelines for the management of ulcerative colitis. Recommendations of the Polish society of gastroenterology and the Polish national consultant in gastroenterology","volume":"18","author":"Eder","year":"2023","journal-title":"Prz. Gastroenterol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1186\/s12876-025-03627-2","article-title":"Efficacy and safety of mirikizumab for ulcerative colitis: a systematic review and meta-analysis of randomized controlled trials","volume":"25","author":"Elainein","year":"2025","journal-title":"BMC Gastroenterol."},{"key":"B29","article-title":"EMA confirms xeljanz (tofacitinib) should be used with caution in patients at high risk of blood clots","year":"2022","journal-title":"EMA Saf. Update"},{"key":"B32","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1038\/s41574-018-0059-4","article-title":"Inflammaging: a new immune-metabolic viewpoint for age-related diseases","volume":"14","author":"Franceschi","year":"2018","journal-title":"Nat. Rev. Endocrinol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1146\/annurev-cellbio-011620-034148","article-title":"B cell immunosenescence","volume":"36","author":"Frasca","year":"2020","journal-title":"Annu. Rev. Cell Dev. Biol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1093\/ibd\/izad132","article-title":"Excessive mitochondrial fission suppresses mucosal repair by impairing butyrate metabolism in colonocytes","volume":"30","author":"Fu","year":"2024","journal-title":"Inflamm. Bowel Dis."},{"key":"B35","doi-asserted-by":"publisher","first-page":"e36693","DOI":"10.1097\/MD.0000000000036693","article-title":"Primary Clostridium difficile infection in patients with ulcerative colitis: case report and literature review","volume":"103","author":"Gao","year":"2024","journal-title":"Med. Baltim."},{"key":"B36","doi-asserted-by":"publisher","first-page":"686","DOI":"10.1093\/ecco-jcc\/jjy214","article-title":"Inflammatory Bowel Disease [IBD] and physical activity: a study on the impact of diagnosis on the level of exercise amongst patients with IBD","volume":"13","author":"Gatt","year":"2019","journal-title":"J. Crohns Colitis"},{"key":"B37","doi-asserted-by":"publisher","first-page":"2928","DOI":"10.1111\/ans.18713","article-title":"Reducing rate of total colectomies for ulcerative colitis but higher morbidity in the biologic era: an 18-year linked data study from New South Wales Australia","volume":"93","author":"Giddings","year":"2023","journal-title":"ANZ J. Surg."},{"key":"B38","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.3390\/nu17081369","article-title":"An assessment of the nutritional status in patients with inflammatory bowel Disease-A matched-pair case-control study","volume":"17","author":"Godala","year":"2025","journal-title":"Nutrients"},{"key":"B93","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1093\/ecco-jcc\/jjac187","article-title":"ECCO guidelines on inflammatory bowel disease and malignancies","volume":"17","author":"Gordon","year":"2023","journal-title":"J. Crohn\u2019s and Colitis."},{"key":"B40","first-page":"669","article-title":"Diagnosis and treatment of inflammatory bowel disease in older patients","volume":"8","author":"Ha","year":"2012","journal-title":"Gastroenterol. Hepatol. (N Y)."},{"key":"B41","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1093\/ecco-jcc\/jjv213","article-title":"European crohn\u2019s and colitis organisation. The first European evidence-based consensus on extra-intestinal manifestations in inflammatory bowel disease","volume":"10","author":"Harbord","year":"2016","journal-title":"J. Crohns Colitis"},{"key":"B42","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1136\/gut.2006.101519","article-title":"Ulcerative colitis: no rise in mortality in a european-wide population based cohort 10 years after diagnosis","volume":"56","author":"H\u00f6ie","year":"2007","journal-title":"Gut"},{"key":"B43","doi-asserted-by":"publisher","first-page":"17562848211023399","DOI":"10.1177\/17562848211023399","article-title":"The elderly IBD patient in the modern era: changing paradigms in risk stratification and therapeutic management","volume":"14","author":"Hong","year":"2021","journal-title":"Ther. Adv. Gastroenterol."},{"key":"B44","doi-asserted-by":"publisher","first-page":"714057","DOI":"10.3389\/fpsyt.2021.714057","article-title":"Depression and anxiety disorders in patients with inflammatory bowel disease","volume":"12","author":"Hu","year":"2021","journal-title":"Front. Psychiatry"},{"key":"B45","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1093\/ibd\/izae245","article-title":"Unmasking the steroid curtain: reevaluating corticosteroid use in IBD clinical trials","volume":"31","author":"Jeffrey","year":"2025","journal-title":"Inflamm. Bowel Dis."},{"key":"B46","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1159\/000502816","article-title":"Therapies in inflammatory bowel disease patients with extraintestinal manifestations","volume":"101","author":"Juillerat","year":"2020","journal-title":"Digestion"},{"key":"B49","doi-asserted-by":"publisher","first-page":"e939412","DOI":"10.12659\/MSM.939412","article-title":"Surgical outcomes in 62 patients with ulcerative colitis: a retrospective, single-center study from Poland","volume":"29","author":"Kampka","year":"2023","journal-title":"Med. Sci. Monit."},{"key":"B50","doi-asserted-by":"publisher","first-page":"655364","DOI":"10.3389\/fphar.2021.655364","article-title":"Prevalence and age structure of polypharmacy in Poland: results of the analysis of the national real-world database of 38 million citizens","volume":"12","author":"Kardas","year":"2021","journal-title":"Front. Pharmacol."},{"key":"B51","doi-asserted-by":"publisher","first-page":"e948912","DOI":"10.12659\/MSM.948912","article-title":"Efficacy of microencapsulated sodium butyrate as Add-On therapy in inducing remission in patients with mild-to-moderate ulcerative colitis: results from a multi-center, double-blind, randomized, placebo-controlled study","volume":"31","author":"Kar\u0142owicz","year":"2025","journal-title":"Med. Sci. Monit."},{"key":"B52","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1155\/2007\/136406","article-title":"Increased risk of colorectal cancer in ulcerative colitis patients diagnosed after 40 years of age","volume":"21","author":"Karvellas","year":"2007","journal-title":"Can. J. Gastroenterol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"194","DOI":"10.5217\/ir.2018.16.2.194","article-title":"Management of inflammatory bowel disease in older persons: evolving paradigms","volume":"16","author":"Kedia","year":"2018","journal-title":"Intest. Res."},{"key":"B54","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1007\/s11894-010-0131-2","article-title":"Intestinal goblet cells and mucins in health and disease: recent insights and progress","volume":"12","author":"Kim","year":"2010","journal-title":"Curr. Gastroenterol. Rep."},{"key":"B55","doi-asserted-by":"publisher","first-page":"420","DOI":"10.5217\/ir.2023.00039","article-title":"Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease","volume":"21","author":"Kim","year":"2023","journal-title":"Intest. Res."},{"key":"B56","doi-asserted-by":"publisher","first-page":"e000361","DOI":"10.1136\/bmjgast-2019-000361","article-title":"Risk of colorectal cancer in a population-based study 20 years after diagnosis of ulcerative colitis: results from the IBSEN study","volume":"7","author":"Klepp","year":"2020","journal-title":"BMJ Open Gastroenterol."},{"key":"B58","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1016\/j.cgh.2014.05.015","article-title":"Risk of lymphoma in patients with inflammatory bowel disease treated with azathioprine and 6-mercaptopurine: a meta-analysis","volume":"13","author":"Kotlyar","year":"2015","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"B59","doi-asserted-by":"publisher","first-page":"8602","DOI":"10.3390\/jcm14238602","article-title":"Physical activity and education in the care of IBD: the role of the physiotherapist\u2014A narrative review","volume":"14","author":"Kov\u00e1cs","year":"2025","journal-title":"J. Clin. Med."},{"key":"B60","doi-asserted-by":"publisher","first-page":"3407","DOI":"10.57187\/s.3407","article-title":"Bone health in patients with inflammatory bowel disease","volume":"154","author":"Kreienbuehl","year":"2024","journal-title":"Swiss Med. Wkly."},{"key":"B61","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1093\/ecco-jcc\/jjab052","article-title":"ECCO guidelines on the prevention, diagnosis, and management of infections in inflammatory bowel disease","volume":"15","author":"Kucharzik","year":"2021","journal-title":"J. Crohns Colitis"},{"key":"B63","doi-asserted-by":"publisher","first-page":"jjaf106","DOI":"10.1093\/ecco-jcc\/jjaf107","article-title":"Roger feakins, on behalf of the European Crohn\u2019s and Colitis Organisation (ECCO), the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), the European Society of Pathology (ESP), and the International Bowel Ultrasonography Group (IBUS), ECCO-ESGAR-ESP-IBUS Guideline on Diagnostics and Monitoring of Patients with Inflammatory Bowel Disease: part 1: initial diagnosis, monitoring of known inflammatory bowel disease, detection of complications","volume":"19","author":"Kucharzik","year":"2025","journal-title":"J. Crohn's Colitis"},{"key":"B65","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/gutjnl-2019-318484","article-title":"British society of gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults","volume":"68","author":"Lamb","year":"2019","journal-title":"Gut"},{"key":"B66","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s43556-024-00207-w","article-title":"Ulcerative colitis: molecular insights and intervention therapy","volume":"5","author":"Liang","year":"2024","journal-title":"Mol. Biomed."},{"key":"B69","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1111\/apt.13294","article-title":"Efficacy and safety of anti-TNF therapy in elderly patients with inflammatory bowel disease","volume":"42","author":"Lobat\u00f3n","year":"2015","journal-title":"Aliment. Pharmacol. Ther."},{"key":"B70","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.crohns.2013.07.002","article-title":"Risk factors for depression in the elderly inflammatory bowel disease population","volume":"8","author":"Long","year":"2014","journal-title":"J. Crohns Colitis"},{"key":"B71","doi-asserted-by":"publisher","first-page":"S798","DOI":"10.1093\/ecco-jcc\/jjaa160","article-title":"Inflammatory bowel disease management during the COVID-19 outbreak: the ten do's and don'ts from the ECCO-COVID taskforce","volume":"14","author":"Magro","year":"2020","journal-title":"J. Crohns Colitis"},{"key":"B73","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.gande.2023.10.003","article-title":"Advancements in malnutrition in elderly inflammatory bowel disease patients","volume":"1","author":"Mao","year":"2023","journal-title":"Gastroenterology and Endosc."},{"key":"B74","doi-asserted-by":"publisher","first-page":"24","DOI":"10.53139\/GP.20253306","article-title":"Clinical implications of Vitamin D deficiency in older adults: An updated review of the literature","volume":"33","author":"Marcin","year":"2025","journal-title":"Gerontol. Pol."},{"key":"B75","doi-asserted-by":"publisher","first-page":"3383","DOI":"10.3390\/nu12113383","article-title":"Fluid intake recommendation considering the physiological adaptations of adults over 65 years: a critical review","volume":"12","author":"Masot","year":"2020","journal-title":"Nutrients"},{"key":"B76","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1093\/ecco-jcc\/jjad025","article-title":"Microbial\u2013immune crosstalk in elderly-onset inflammatory bowel disease: unchartered territory","volume":"17","author":"Meng","year":"2023","journal-title":"J. Crohn's Colitis"},{"key":"B77","doi-asserted-by":"publisher","first-page":"e004587","DOI":"10.1136\/bmjopen-2013-004587","article-title":"Corticosteroids and risk of gastrointestinal bleeding: a systematic review and meta-analysis","volume":"4","author":"Narum","year":"2014","journal-title":"BMJ Open"},{"key":"B78","volume-title":"Colonoscopic surveillance for prevention of colorectal cancer in people with ulcerative colitis, crohn's disease or adenomas","year":"2011"},{"key":"B79","doi-asserted-by":"publisher","first-page":"66","DOI":"10.3390\/diseases6030066","article-title":"Appetite, metabolism and hormonal regulation in normal ageing and dementia","volume":"6","author":"Nifli","year":"2018","journal-title":"Diseases"},{"key":"B80","doi-asserted-by":"publisher","first-page":"51","DOI":"10.4292\/wjgpt.v7.i1.51","article-title":"Elderly patients and inflammatory bowel disease","volume":"7","author":"Nimmons","year":"2016","journal-title":"World J. Gastrointest. Pharmacol. Ther."},{"key":"B81","doi-asserted-by":"publisher","first-page":"3129","DOI":"10.1007\/s10620-021-07129-5","article-title":"Safety and efficacy of vedolizumab Versus tumor necrosis factor \u03b1 antagonists in an elderly IBD population: a single institution retrospective experience","volume":"67","author":"Pabla","year":"2022","journal-title":"Dig. Dis. Sci."},{"key":"B82","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1093\/ecco-jcc\/jjy040","article-title":"Colectomy rates in ulcerative colitis are low and decreasing: 10-Year Follow-up data from the Swiss IBD cohort study","volume":"12","author":"Parragi","year":"2018","journal-title":"J. Crohns Colitis"},{"key":"B84","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1007\/s11938-019-00258-x","article-title":"Sleep disturbances in the elderly patient with inflammatory bowel disease","volume":"17","author":"Qazi","year":"2019","journal-title":"Curr. Treat. Options Gastroenterol."},{"key":"B85","doi-asserted-by":"publisher","first-page":"733992","DOI":"10.3389\/fcimb.2022.733992","article-title":"The gut microbiota in inflammatory bowel disease","volume":"12","author":"Qiu","year":"2022","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B86","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1093\/ecco-jcc\/jjab178","article-title":"ECCO guidelines on therapeutics in ulcerative colitis: medical treatment","volume":"16","author":"Raine","year":"2021","journal-title":"J. Crohns Colitis"},{"key":"B87","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1128\/JCM.05176-11","article-title":"Clostridium difficile carriage in elderly subjects and associated changes in the intestinal microbiota","volume":"50","author":"Rea","year":"2012","journal-title":"J. Clin. Microbiol."},{"key":"B88","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/s11938-024-00467-z","article-title":"Risk factors, presentation, diagnosis, and treatment of C. difficile infection in the older adult","volume":"23","author":"Reznik","year":"2025","journal-title":"Curr. Treat. Options Gastro"},{"key":"B89","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1053\/j.gastro.2021.07.042","article-title":"Extraintestinal manifestations of inflammatory bowel disease: current concepts, treatment, and implications for disease management","volume":"161","author":"Rogler","year":"2021","journal-title":"Gastroenterology"},{"key":"B90","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1111\/apt.17039","article-title":"Sources of excess steroid prescriptions and clinical adverse outcomes associated with steroid excess in patients with inflammatory bowel disease: the Leeds IBD steroids study","volume":"56","author":"Rosiou","year":"2022","journal-title":"Aliment. Pharmacol. Ther."},{"key":"B91","doi-asserted-by":"publisher","first-page":"384","DOI":"10.14309\/ajg.0000000000000152","article-title":"ACG clinical guideline: ulcerative colitis in adults","volume":"114","author":"Rubin","year":"2019","journal-title":"Am. J. Gastroenterol."},{"key":"B92","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1097\/DCR.0000000000003137","article-title":"Tofacitinib is associated with increased risk of postoperative venous thromboembolism in patients with ulcerative colitis","volume":"67","author":"Russell","year":"2024","journal-title":"Dis. Colon and Rectum"},{"key":"B94","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.cgh.2019.04.059","article-title":"Tofacitinib treatment is associated with modest and reversible increases in serum lipids in patients with ulcerative colitis","volume":"18","author":"Sands","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"B95","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1159\/000505368","article-title":"On behalf of Swiss IBDnet, an official working group of the Swiss society of gastroenterology. Nutrition in inflammatory bowel disease","volume":"101","author":"Schreiner","year":"2020","journal-title":"Digestion"},{"key":"B106","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1016\/S2468-1253(22)00358-2","article-title":"Management of inflammatory bowel diseases in older adults","volume":"8","author":"Singh","year":"2023","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"B96","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1016\/j.dld.2022.12.024","article-title":"Management of inflammatory bowel disease in the elderly: a review","volume":"55","author":"Sousa","year":"2023","journal-title":"Dig. Liver Dis."},{"key":"B97","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/s00384-024-04779-5","article-title":"The fate of the rectum in ulcerative colitis at index surgery and beyond-a contemporary cohort","volume":"40","author":"Stephens","year":"2025","journal-title":"Int. J. Colorectal Dis."},{"key":"B98","doi-asserted-by":"publisher","first-page":"4678","DOI":"10.3390\/jcm13164678","article-title":"Safety and effectiveness of thiopurines and small molecules in elderly patients with inflammatory bowel diseases","volume":"13","author":"Strig\u00e1\u010d","year":"2024","journal-title":"J. Clin. Med."},{"key":"B99","doi-asserted-by":"publisher","first-page":"1923","DOI":"10.1111\/apt.70140","article-title":"Real-world effectiveness and safety of mirikizumab induction therapy in patients with ulcerative colitis: a multicentre retrospective observational study","volume":"61","author":"Takagi","year":"2025","journal-title":"Aliment. Pharmacol. Ther."},{"key":"B100","doi-asserted-by":"publisher","first-page":"2767","DOI":"10.3390\/jcm13102767","article-title":"Inflammatory bowel diseases in the elderly: a focus on disease characteristics and biological therapy patterns","volume":"13","author":"Talar-Wojnarowska","year":"2024","journal-title":"J. Clin. Med."},{"key":"B102","doi-asserted-by":"publisher","first-page":"1603847","DOI":"10.3389\/fragi.2025.1603847","article-title":"Drug-mediated disruption of the aging gut microbiota and mucosal immune system","volume":"6","author":"Totleben","year":"2025","journal-title":"Front. Aging"},{"key":"B103","doi-asserted-by":"publisher","first-page":"2142","DOI":"10.1136\/gutjnl-2018-317571","article-title":"Structural weakening of the colonic mucus barrier is an early event in ulcerative colitis pathogenesis","volume":"68","author":"van der Post","year":"2019","journal-title":"Gut"},{"key":"B104","doi-asserted-by":"publisher","first-page":"313","DOI":"10.14309\/ajg.0000000000003076","article-title":"FACG2. Diagnosis and management of Clostridioides difficile in inflammatory bowel disease","volume":"120","author":"Vaughn","year":"2025","journal-title":"Am. J. Gastroenterology"},{"key":"B105","doi-asserted-by":"publisher","first-page":"3202","DOI":"10.3390\/jcm14093202","article-title":"Nutritional deficiencies and reduced bone mineralization in ulcerative colitis","volume":"14","author":"Vernia","year":"2025","journal-title":"J. Clin. Med."},{"key":"B107","doi-asserted-by":"publisher","first-page":"101533","DOI":"10.1016\/j.jcmgh.2025.101533","article-title":"Goblet cell loss linked to NOD2 and secondary resection in crohn's disease is induced by dysbiosis and epithelial MyD88","volume":"19","author":"Wong","year":"2025","journal-title":"Cell Mol. Gastroenterol. Hepatol."},{"key":"B108","doi-asserted-by":"publisher","first-page":"1608025","DOI":"10.3389\/fcimb.2025.1608025","article-title":"Gut microbiota dysbiosis in inflammatory bowel disease: interaction with intestinal barriers and microbiota-targeted treatment options","volume":"15","author":"Xie","year":"2025","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"B109","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1155\/2022\/1498293","article-title":"Risk factors for worsening of bone loss in patients newly diagnosed with inflammatory bowel disease","volume":"2022","author":"Yin","year":"2022","journal-title":"Gastroenterol. Res. Pract."},{"key":"B110","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1056\/NEJMoa2109927","article-title":"ORAL surveillance investigators. Cardiovascular and cancer risk with tofacitinib in rheumatoid arthritis","volume":"386","author":"Ytterberg","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"B111","doi-asserted-by":"publisher","first-page":"1019313","DOI":"10.3389\/fimmu.2022.1019313","article-title":"Senescence-associated secretory phenotype and its impact on oral immune homeostasis","volume":"13","author":"Yue","year":"2022","journal-title":"Front. Immunol."},{"key":"B112","doi-asserted-by":"publisher","first-page":"16194","DOI":"10.20452\/pamw.16194","article-title":"Nationwide data on epidemiology of inflammatory bowel disease in Poland between 2009 and 2020","volume":"132","author":"Zag\u00f3rowicz","year":"2022","journal-title":"Pol. Arch. Intern Med."},{"key":"B113","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1186\/s12876-020-01296-x","article-title":"Elderly-onset vs adult-onset ulcerative colitis: a different natural history?","volume":"20","author":"Zammarchi","year":"2020","journal-title":"BMC Gastroenterol."},{"key":"B114","doi-asserted-by":"publisher","first-page":"e11790","DOI":"10.1002\/acr2.11790","article-title":"Understanding cardiovascular events with JAK inhibitors: Tofacitinib reduces synovial and vascular inflammation but not the prothrombotic effects of inflammatory cytokines on endothelium","volume":"7","author":"Zavoriti","year":"2025","journal-title":"ACR Open Rheumatol."},{"key":"B115","doi-asserted-by":"publisher","first-page":"1814","DOI":"10.1111\/liv.15339","article-title":"Prevalence of inflammatory bowel disease in patients with primary sclerosing cholangitis: a systematic review and meta-analysis","volume":"42","author":"Zhang","year":"2022","journal-title":"Liver Int."},{"key":"B116","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s12979-024-00494-5","article-title":"Disrupted mitochondrial morphology and function exacerbate inflammation in elderly-onset ulcerative colitis","volume":"22","author":"Zhang","year":"","journal-title":"Immun. Ageing"},{"key":"B117","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1186\/s12876-025-04059-8","article-title":"Clinical application of pre-rehabilitation concept on comfort colonoscopy in Chinese elderly patients: a randomised controlled trial","volume":"25","author":"Zhang","year":"","journal-title":"BMC Gastroenterol."},{"key":"B118","doi-asserted-by":"publisher","first-page":"5363261","DOI":"10.1155\/2019\/5363261","article-title":"Risk of colorectal cancer in ulcerative colitis patients: a systematic review and meta-analysis","volume":"2019","author":"Zhou","year":"2019","journal-title":"Gastroenterol. Res. Pract."},{"key":"B119","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1002\/jgh3.12612","article-title":"Clinical characteristics of ulcerative colitis in elderly patients","volume":"5","author":"Zhu","year":"2021","journal-title":"JGH Open"}],"container-title":["Frontiers in Aging"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fragi.2026.1815043\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:36:21Z","timestamp":1785821781000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fragi.2026.1815043\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":103,"alternative-id":["10.3389\/fragi.2026.1815043"],"URL":"https:\/\/doi.org\/10.3389\/fragi.2026.1815043","relation":{},"ISSN":["2673-6217"],"issn-type":[{"value":"2673-6217","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]},"article-number":"1815043"}}