Study objectives: To evaluate the differences in the
clinical, radiologic, and laboratory features of pulmonary tuberculosis
(TB) in older patients, as compared to younger patients.
Design: A meta-analysis (the Schmidt-Hunter method) of
published works found in MEDLINE and other sources was performed. A
total of 12 studies were collected, and each variable was submitted to
Results: No differences were found
between older (≥ 60 years old) and younger TB patients with respect
to male predominance, evolution time before diagnosis, prevalence of
cough, sputum production, weight loss, fatigue/malaise, radiographic
upper lobes lesions, positive acid-fast bacilli in sputum, anemia or
hemoglobin level, and serum aminotransferases. A lower prevalence of
fever, sweating, hemoptysis, cavitary disease, and positive purified
protein derivative, as well as lower levels of serum albumin and
blood leukocytes were noticed among older patients. In addition, the
older population had a greater prevalence of dyspnea and some
concomitant conditions, such as cardiovascular disorders, COPD,
diabetes, gastrectomy history, and malignancies.
Conclusions: This meta-analytical review identified the
main differences of older TB patients, as compared to younger TB
patients, that should be considered during the diagnostic evaluation.
Most of these differences are explained by the already known
physiologic changes that occur during aging.