TUBERCULOSIS IN THE ELDERLY

After an initial decline in the early 1980s, tuberculosis has reemerge d as an important disease in the United States, Western Europe and man y developing countries. The elderly among all ethnic groups and both s exes are at special risk for infection with Mycobacterium tuberculosis , because of a combination of biological factors: underlying disease, compromised nutrition and immune status, medications, and possible rac ial susceptibility as well as socio-economic factors: poverty, healthc are access and living conditions. Elderly residents of long-term care facilities are particularly at risk both for tuberculosis reactivation and new infection. Clarity in the understanding about the global epid emiology, pathogenesis, unique clinical features, diagnosis, managemen t and prevention of tuberculosis in the elderly is thus imperative in the approach to this disease in the elderly.