[Clinical characteristics of elderly patients with tuberculosis]

The purpose of this report is to elucidate the characteristics of elderly patients with tuberculosis (TB), based on 235 patients hospitalized in our institution from January 1999 to October 2001. The mean age of all patients was 60.8 years old and the male-to-female ratio was 2.1:1. The clinical features were compared between 121 patients aged 65 years old or more (elderly group) and 114 patients younger than 65 years old (non-elderly group). The time lag between onset of the symptoms and the first visit to a doctor was 19 days in the elderly and 49 days in the non-elderly (P < 0.01). Previous therapy, extrapulmonary TB, and underlying diseases were significantly frequent in the elderly (P < 0.05). Cavitation on chest X-ray film was found in 23% of the elderly and in 40% of the non-elderly (P < 0.01). The frequency of positive smear was similar in the two groups. Peripheral blood lymphocyte count, serum total protein, albumin and total cholesterol were lower in the elderly who died during admission than in the living elderly (P < 0.01). There was no significant difference in mortality due to TB between the two groups, although deaths due to non-tuberculous diseases were more frequent in the elderly. Pneumonia and other infectious diseases accounted for 50% of deaths in the elderly. Nutrition and infection other than TB should be taken into consideration in treating elderly patients with TB.