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Tuberculosis in the elderly.

S Rajagopalan1, T T Yoshikawa

  • 1Department of Internal Medicine, Division of Infectious Disease, Mailpoint 11, Room 4015, King-Drew Medical Center, 12021 South Wilmington Avenue, Los Angeles, CA 90059, USA. shrajago@cdrewu.edu

Zeitschrift Fur Gerontologie Und Geriatrie
|December 29, 2000
PubMed
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Tuberculosis (TB) remains a global threat, especially for the elderly who are at higher risk for infection and present with atypical symptoms. This review covers TB epidemiology, unique clinical considerations, and management strategies for older adults.

Area of Science:

  • Infectious Diseases
  • Geriatrics
  • Public Health

Background:

  • Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), is a leading infectious disease globally, with a significant portion of the world's population infected.
  • The World Health Organization declared TB a global health emergency in 1993 due to its rampant spread.
  • Despite control efforts, TB remains a challenge, particularly in high-risk groups like the elderly, who represent a large reservoir of infection.

Purpose of the Study:

  • To discuss the global epidemiology, pathogenesis, and immunologic aspects of TB in the elderly.
  • To highlight unique clinical considerations and diagnostic challenges of TB in older adults.
  • To review current treatment and prevention strategies for TB, including latent TB infection, in the geriatric population.

Main Methods:

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  • Review of global TB epidemiology, focusing on the geriatric population.
  • Analysis of pathogenesis and immunologic changes associated with aging and Mtb infection.
  • Examination of clinical presentations, diagnostic difficulties, and therapeutic challenges in elderly TB patients.

Main Results:

  • Older adults are a significant reservoir for TB infection, often presenting with atypical or non-specific symptoms that can mimic age-related diseases.
  • Biological changes with aging, comorbidities, and malnutrition can impair immune responses and increase susceptibility to Mtb.
  • TB diagnosis in the elderly is often delayed, and treatment is complicated by a higher incidence of adverse drug reactions and polypharmacy.

Conclusions:

  • TB prevention and control in the elderly remain a significant clinical and epidemiological challenge.
  • Optimal management requires addressing chronic diseases, minimizing invasive procedures, limiting polypharmacy, and providing nutritional support.
  • Targeted testing and treatment of latent TB infection are crucial for this vulnerable population.