Does aging modify pulmonary tuberculosis? A meta-analytical review

Study objectives: To evaluate the differences in the clinical, radiologic, and laboratory features of pulmonary tuberculosis (TB) in older patients, a s compared to younger patients. Design: A meta-analysis (the Schmidt-Hunter method): of published works fou nd in MEDLINE and other sources was pet-formed. A total of 12 studies were collected, and each variable was submitted to meta-analysis, Results: No differences were found between older (greater than or equal to 60 years old) and younger TB patients with respect to male predominance, ev olution time before diagnosis, prevalence of cough, sputum production, weig ht loss, fatigue/malaise, radiographic:upper lobes lesions, positive acid-f ast bacilli in sputum, anemia or hemoglobin level, and serum aminotransfera ses. A lower prevalence of fever, sweating, hemoptysis, cavitary disease, a nd positive:purified protein derivative, as well as-lower levels of serum a lbumin and blood leukocytes were noticed among older patients, In addition, the older population had a greater prevalence of dyspnea and some concomit ant conditions, such as cardiovascular disorders, COPD, diabetes, gastrecto my 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 cons idered during the diagnostic evaluation, Most of these differences are expl ained by the already known physiologic changes that occur during aging.