Epidemiology of geriatric tuberculosis: a five-year retrospective study from a tertiary care hospital in India.

BACKGROUND: Ageing affects the clinical presentation of diseases due to associated comorbidities, often leading to diagnostic imprecision and specialized treatment needs in healthcare systems that are not well-equipped to address such challenges. Robust data analysis of geriatric tuberculosis (TB) is thus essential for preparedness to improve outcomes in this expanding vulnerable population. This study aims to identify the epidemiological, clinical, and comorbidity profiles of TB across various age cohorts, with a specific emphasis on the geriatric population.

METHODS: In this retrospective study, 5-year (2020–2024) data using 41,751 confirmed TB cases with a mean age of 33.37 ± 18.25 years were analyzed at a tertiary care hospital in Lucknow, India. Data were analyzed for age, gender, site of infection, drug resistance patterns, and associated comorbidities. Comparative assessments were performed among the geriatric cohort (≥ 60 years; mean age, 67.88 ± 6.63 years), the adult group (19–59 years; mean age, 33.74 ± 11.49 years), and the pediatric group (0–18 years; mean age, 12.82 ± 5.25 years).

RESULTS: Among the 41,751 analyzed TB cases, the geriatric cohort ( = 5,335; 12.77%) showed a male predominance (78.16%) and a significantly higher prevalence of pulmonary TB (68.53%) compared to the adult and pediatric cohorts. Drug susceptibility testing (available for = 20,000) identified 1,142 geriatric patients with drug-resistant TB. Although overall resistance rates were lower compared to adults, the proportions of mono-resistant, MDR, and pre-XDR strains in geriatric patients were significant. Among patients with available comorbidity data, the geriatric cohort comprised a substantial proportion of cases, representing 29.94% (112/374) of diabetic patients, 16.03% (17/106) of alcohol users, and 14.22% (62/436) of tobacco users.

CONCLUSIONS: TB in the geriatric cohort showed male predominance and was characterized by primary pulmonary infection with a significant contribution to the drug resistance burden. Diabetes mellitus was found to be the most common associated illness in the elderly. Thus, improving TB treatment outcomes requires comprehensive screening and age-specific management strategies that account for both resistance patterns and comorbid conditions.

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