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Tuberculosis in the elderly. Epidemiology and optimal management

P D Davies1

  • 1Tuberculosis Research Unit, Cardiothoracic Centre, Liverpool, England.

Drugs & Aging
|June 1, 1996
PubMed
Summary

Tuberculosis disproportionately affects the elderly, presenting atypically and leading to higher mortality. This demographic requires tailored diagnostic and treatment approaches for effective tuberculosis management.

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Area of Science:

  • Gerontology
  • Infectious Diseases
  • Public Health

Background:

  • The elderly are the primary reservoir for tuberculosis in developed nations, despite a focus on HIV-associated cases.
  • Tuberculosis incidence may be rising in some developing regions.
  • HIV-associated tuberculosis often affects younger adults, diverting attention from the elderly population.

Purpose of the Study:

  • To highlight the significant burden of tuberculosis in the elderly population.
  • To discuss the challenges in diagnosing and treating tuberculosis in older adults.
  • To emphasize the increased mortality risk associated with tuberculosis in the elderly.

Main Methods:

  • Review of clinical presentation, diagnostic challenges, and treatment outcomes in elderly tuberculosis patients.
  • Analysis of atypical disease manifestations in older adults.
  • Examination of treatment-related adverse effects and mortality rates.

Main Results:

  • Elderly patients often exhibit uncharacteristic tuberculosis symptoms, including insidious onset and fewer classic signs like fever or hemoptysis.
  • Extrapulmonary tuberculosis and atypical chest X-ray findings are more common in the elderly.
  • Higher incidence of adverse drug reactions and need for modified, potentially less effective, treatment regimens.
  • Mortality rates in elderly tuberculosis patients, especially those over 70, exceed 30%.

Conclusions:

  • Tuberculosis diagnosis and management in the elderly are complicated by atypical presentations and increased risks.
  • The elderly represent a critical population for tuberculosis control, requiring specific clinical attention.
  • Higher mortality underscores the urgent need for improved diagnostic and therapeutic strategies for tuberculosis in older adults.

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