Disease burden of inflammatory bowel disease and subtypes in older adults in 172 high- and middle-income countries: Trends from 2000 to 2023 and projections to 2040

Background: Inflammatory bowel disease (IBD) in older adults has become a new concern in high- and middle-income countries (HMICs). However, the latest disease burden and temporal trends remain to be systemically clarified. Methods: Disease burden data of 172 HMICs were extracted from GBD 2023, including incidence, prevalence, and DALYs on IBD, ulcerative colitis (UC), and Crohn’s disease (CD) among older adults. Stratified analysis was performed based on disease subtype, sex, and gross national income (GNI). A correlation analysis was utilized to evaluate the association of the indicators and income levels. Temporal trends (2000-2023) and future burden up to 2040 were further analyzed. Results: In 2023, the incidence, prevalence and DALY rate of IBD in older adults were highest in high-income countries (HCs), and all indicators showed a positive correlation with GNI per capita. From 2000 to 2023, the most significant increase in incidence was observed in Libya, China, and Lebanon. The burden of UC was greater than that of CD, and the incidence ratio of UC/CD was negatively correlated with GNI per capita. The incidence of UC was higher among older males, whereas CD had a higher incidence among older females. Until 2040, the prevalence of IBD and its subtypes would increase across all GNI levels. Notably, the prevalence of UC in lower-middle-income countries (LMCs) may double. Conclusions: The disease burden of IBD among older adults in HMICs continues to increase. Future strategies should be customized based on each country’s specific needs and development stage.