2001 - Tuberculosis and Elderly in Hong Kong
Dr. Tam Wai On, Grantham Hospital
Background
Tuberculosis and aging are important medical issues in Hong Kong nowadays. Previous studies, mainly conducted in the western world, showed that the characteristics in young and elderly tuberculosis patients were quite different. Nevertheless, there are only limited data on the latest condition in Hong Kong.
Methods
Hospital records of tuberculosis patients greater than 65 years old, who were admitted between January 1996 to December 1996 to the Tuberculosis and Chest Unit of Grantham Hospital, were reviewed. Patients with the same diagnosis but the age were younger than 65, acted as control. Their background data, clinical presentation of disease, investigations, treatment, side effects and outcome were recorded and analyzed.
Results
In total, 128 young and 107 elderly patients with active tuberculosis were recruited. The elderly patients had a smaller body mass index (18.9 vs 20.3, P=0.002) and more underlying medical problems (74 Vs 49, P<0.0005) than the younger patients. They were also financially and socially dependent. They were frequently admitted because of frailty and concomitant medical disease. In the elderly group, there was more malaise, weight loss and shortness of breath on presentation and their chest x-ray involvement tended to be more extensive. They were likely to have anemia, low albumin and lymphocyte and high ESR (P<0.0005) before treatment. The most common side effects were hepatitis and skin rash and these problems were also more common in elderly (P =0.002 & 0.04 respectively).
Conclusion
Medical practitioners in Hong Kong should be aware of the difference in clinical presentation of tuberculosis in the elderly.
