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Characteristics of tuberculosis in elderly adults: A multicenter French study
M Trichet1, J-P Lanoix2, S Diamantis3
1Service de Maladies Infectieuses, Centre Hospitalier Intercommunal de Villeneuve Saint Georges, Villeneuve Saint Georges, France.
Infectious Diseases Now
|December 9, 2025
Summary
Tuberculosis (TB) in elderly adults often presents atypically, with weight loss being a key indicator of delayed diagnosis and increased mortality. Standard treatment remains effective despite low drug resistance in this population.
Area of Science:
- Gerontology
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) incidence is high in French elderly adults.
- Immunosenescence and comorbidities complicate TB diagnosis and treatment in this demographic.
- Limited recent data exists on TB characteristics and outcomes in the elderly.
Purpose of the Study:
- To describe clinical and microbiological features of TB in elderly patients (≥75 years).
- To identify factors associated with 2-year mortality in this population.
Main Methods:
- Retrospective, multicenter study of 295 patients aged ≥75 years diagnosed with TB (2010-2020).
- Multivariate analysis to determine factors independently associated with 2-year mortality.
Main Results:
- Weight loss was the most frequent symptom (60.3%), linked to diagnostic delays.
- Pulmonary TB was predominant (63.1%); higher culture positivity in this group and older patients.
- Overall 2-year mortality was 31.3%, associated with renal failure, nursing home residence, and weight loss.
Conclusions:
- TB presents atypically in the elderly, with weight loss as a significant prognostic symptom.
- Standard quadruple therapy is commonly used and safe, despite low isoniazid resistance.
- Factors like renal failure, institutionalization, and weight loss predict higher mortality in elderly TB patients.
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