title: Profile and treatment outcomes of elderly patients with tuberculosis in Delhi, India: implications for their management.
abstract: BACKGROUND
  Given India's high rate of TB, rising burden of non-communicable diseases (NCDs) and growing elderly population, elderly TB patients may be at higher risk of adverse outcomes including death, loss-to-follow-up (LTFU) and treatment failure. This may call for modifications in their management. This study thus aimed to compare the profile and treatment outcomes between elderly (≥60 years) and non-elderly (15-59 years) TB patients.
  
  
  METHODS
  This was a retrospective cohort study using routinely-collected programme data from a chest clinic in Delhi, India. It included all elderly and selected non-elderly TB patients registered for treatment between 2005 and 2010. Data on patients' clinical and demographic characteristics and treatment outcomes were analysed.
  
  
  RESULTS
  There were 812 elderly and 1624 non-elderly TB patients. Elderly patients were more likely to be male (63.2% vs 51.1%) and have smear-positive TB (56.0% vs 47.4%). Adverse outcomes were more frequent among elderly patients (adjusted OR 1.9, 95% CI: 1.5-2.4), specifically deaths (adjusted OR 5.0, 95% CI: 3.1-8.1) and lost-to-follow-up (adjusted OR 1.4, 95% CI: 1.0-1.9).
  
  
  CONCLUSIONS
  The profile and worse outcomes of elderly Indian TB patients may be indicative of co-existing NCDs. This needs further investigation and likely calls for a more comprehensive and intensive approach to their management.
authors.affiliation: Department of Community Medicine, University College of Medical Sciences and GTB Hospital, Delhi, India.
authors.forename: S
authors.initials: S
authors.lastname: Patra
authors.forename: S
authors.initials: S
authors.lastname: Lukhmana
authors.forename: K
authors.initials: K
authors.lastname: Tayler Smith
authors.forename: A T
authors.initials: AT
authors.lastname: Kannan
authors.forename: S
authors.initials: S
authors.lastname: Satyanarayana
authors.forename: D A
authors.initials: DA
authors.lastname: Enarson
authors.forename: R K
authors.initials: RK
authors.lastname: Nagar
authors.forename: M
authors.initials: M
authors.lastname: Marcel
authors.forename: T
authors.initials: T
authors.lastname: Reid
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: Elderly; India; Treatment outcomes; Tuberculosis