CHARACTERISTICS OF ACQUIRED-IMMUNODEFICIENCY-SYNDROME IN OLDER ADULTS

OBJECTIVE: To examine demographic and clinical features of older AIDS patients in comparison with younger individuals. DESIGN: Data base rev iew. SETTING: Maryland AIDS Registry from 1981 through the end of 1994 . PARTICIPANTS: All registered Maryland AIDS cases greater than or equ al to 60 years of age at diagnosis and all Maryland AIDS cases aged 20 to 39. MAIN OUTCOME MEASURES: Demographic features, mode of transmiss ion and change in mode over time, clinical presentations, CD4+ counts, and survival time. RESULTS: A total of 321 (2.7%) AIDS cases diagnose d in Maryland were people 60 years of age or older compared with 7511 cases (63.9%) in people aged 20 to 39 years. The proportion of whites was higher in the older group, but the gender distribution was similar to younger counterparts. Transfusion was the primary cause of exposur e of 32% of the older people with AIDS; however, during the last few y ears, sexual transmission and drug abuse have been implicated more fre quently. Twelve percent of older patients had no reported risk factors compared with 4% of younger AIDS patients. The most common presenting AIDS indicator disease in older cases was Pneumocystis carinii pneumo nia. Wasting syndrome, candidiasis, and HIV encephalopathy also occurr ed frequently. Median life span was 9 months compared with 22 months i n the young. CONCLUSION: Our study demonstrates that transfusion is no longer the leading cause of AIDS in older people in Maryland. The rel atively increased prominence of transmission by other modes in this ag e group raises the importance of preventive and educational measures. Older patients generally have a shorter survival than younger individu als.