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Clinical spectrum of TB in elderly in a TB & respiratory institution
Rupak Singla1, Amitesh Gupta2, Nilotpal Bhattacherjee1
1Department of Tuberculosis and Chest Diseases, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, 110030, India.
Insights
Tuberculosis (TB) disproportionately affects young adults but presents atypically in the elderly, leading to diagnostic delays and poorer outcomes. Special attention is needed for TB management in older populations due to increased risks and complications.
Area of Science:
- Public Health
- Gerontology
- Infectious Diseases
Background:
- Tuberculosis (TB) poses a significant global health burden, particularly in developing nations.
- While TB predominantly impacts the young, atypical presentations in children and the elderly present unique challenges.
- National TB programs require tailored strategies to address these vulnerable demographics.
Observation:
- Elderly individuals with TB often exhibit non-standard symptoms, increasing the likelihood of misdiagnosis.
- Delayed diagnosis in the elderly frequently results in advanced-stage disease detection.
- The aging population faces heightened risks of adverse drug reactions and requires careful dosage adjustments for TB treatment.
Findings:
- Atypical TB presentation in the elderly complicates epidemiological surveillance and diagnosis.
- Management challenges include drug dosage adjustments and a higher incidence of adverse drug reactions.
- Mortality rates for TB are notably higher in the elderly compared to younger patient cohorts.
Implications:
- Specialized clinical attention and diagnostic protocols are crucial for TB in the elderly.
- Enhanced management strategies are necessary to mitigate complications and improve treatment outcomes in older adults.
- Public health initiatives must incorporate age-specific considerations for effective TB control in aging populations.
Abstract:
Tuberculosis has maximum burden among young population in developing countries like India. However, children and elderly form a special group where TB may have atypical presentation. This presents with epidemiological, diagnostic and treatment challenges in these groups which may need special attention in the national programmes for TB. Due to atypical presentation, elderly population is vulnerable to frequent misdiagnosis and disease may already be in advanced stage when correct diagnosis is made. Not only this, adjustment of drug dosages and high chances of adverse drug reaction make the management of TB more complicated in elderly. Mortality due to TB is also higher in this group as compared to young patients of TB. This view point briefly highlights the epidemiological, clinical and disease outcome aspects of TB disease in elderly patients.
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