Clinical characteristics of pulmonary tuberculosis in elderly Japanese patients

<b>Background:</b> Japan is an aging society, and pulmonary tuberculosis (PTB) is likely to become an increasing problem in elderly patients. <b>Aims and Objectives:</b> The aim was to elucidate the current status and challenges of PTB in elderly patients. <b>Methods:</b> Elderly patients diagnosed with active PTB by culture from April 2006 to March 2017 were retrospectively reviewed. The patients were divided into those aged ≥75 years (elderly) and those aged &lt;75 years (younger). The presenting symptoms, radiologic findings, laboratory data, Eastern Cooperative Oncology group performance status (PS), and prognosis were compared between the groups. <b>Results:</b> There were 121 patients (76 men, 45 women) with a median age of 71 (27–97) years, including 65 elderly and 56 younger patients. Respiratory symptoms were more common in the younger group, whereas general symptoms were more frequent in the elderly group. Complications of malnutrition and worse PS (3 or 4) were more common in the elderly group. The radiologic features in the elderly group were extensive infiltration and pleurisy. Serum albumin was significantly lower in the elderly group (2.97±0.75 g/dL vs. 3.88±0.60 g/dL; p&lt;0.001). The mortality rate during TB therapy was higher in the elderly group (23.1% vs. 7.1%; p=0.01). Most survivors with poor PS were transferred to nursing homes or private hospitals. <b>Conclusion:</b> Elderly patients with PTB were likely to present with non-specific symptoms and extensive radiologic findings. Moreover, they often had comorbidities of malnutrition and incapacitation. To improve this situation, a high index of suspicion for PTB is needed in this group, and such aspects as nutrition and rehabilitation require more attention.