title: [Clinical investigation among elderly patients with tuberculosis].
abstract: OBJECTIVE
  We discussed the factors which may confuse diagnosis and treatment of tuberculosis (TB) in elderly patients, in order to improve the situation.
  
  
  METHODS
  414 patients who were hospitalized for active tuberculosis in Tokyo National Hospital were divided into three groups according to their ages (in years): less than 65, 65 to 74, and greater than 75. The three groups were compared in terms of performance status (PS), serum albumin level (whether over 3 g/dl or not), underlying diseases, symptoms at onset, sputum smear findings for acid-fast bacilli, presence or absence of cavitary lesion, regimen of treatment, adverse reaction to medications, and treatment outcome.
  
  
  RESULTS
  The older group had significantly poorer PS (3 or 4), lower albumin level, more complications, a larger proportion of non-respiratory to respiratory symptoms, less cavity formation, less likelihood of continuing to take drugs regularly and higher mortality. It is supposed that these characteristics are mostly due to the aging itself.
  
  
  CONCLUSIONS
  Diagnosing and treating active tuberculosis among elderly people is difficult because of nonspecific and thus confusing findings due to other diseases or aging. Delay in diagnosis and start of treatment makes prognosis of their TB poorer. To improve this situation we should keep a high index to TB and make better use of novel diagnostic technologies. For satisfactory treatment that allows maintenance of a high level of activity of daily life, it is necessary to pay more attention to such aspects as nutrition and rehabilitation and to offer appropriate supports.
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Tokyo National Hospital, 3-1-1, Takeoka, Kiyose-shi, Tokyo 204-8585, Japan. etoyota-in@tokyo-hosp.jp
authors.forename: Emiko
authors.initials: E
authors.lastname: Toyota
authors.forename: Kazuko
authors.initials: K
authors.lastname: Machida
authors.forename: Naohiro
authors.initials: N
authors.lastname: Nagayama
authors.forename: Akira
authors.initials: A
authors.lastname: Yamane
authors.forename: Kosaku
authors.initials: K
authors.lastname: Komiya
authors.forename: Saburo
authors.initials: S
authors.lastname: Ito
authors.forename: Junichi
authors.initials: J
authors.lastname: Suzuki
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Kashizaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shimada
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Matsui
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kawashima
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Ohshima
authors.forename: Junko
authors.initials: J
authors.lastname: Suzuki
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Ariga
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Masuda
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Matsui
authors.forename: Atsuhisa
authors.initials: A
authors.lastname: Tamura
authors.forename: Shinji
authors.initials: S
authors.lastname: Teramoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nagai
authors.forename: Shinobu
authors.initials: S
authors.lastname: Akagawa
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Shoji
authors.forename: Akira
authors.initials: A
authors.lastname: Hebisawa
authors.forename: Yutsuki
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014376:Tuberculosis / Q000401:mortality / Q000503:physiopathology