According to Master, Doctor Dang Thanh Do, from the Respiratory Department at Tam Anh General Hospital Ha Noi, tuberculosis can affect many organs, but it is most common in the lungs. In older adults, the disease often begins subtly with symptoms such as a cough lasting over three weeks, which may include phlegm or blood, shortness of breath, chest pain when breathing deeply, accompanied by weight loss, a low-grade fever, night sweats, fatigue, and loss of appetite. However, these vague symptoms of pulmonary tuberculosis are easily mistaken for chronic diseases or changes due to aging, making the elderly a high-risk group for developing the disease and experiencing late diagnosis. Below are common reasons contributing to this susceptibility.

Age-related immune system decline

The aging process weakens the immune system, affecting both the number and function of protective cells. This decline in T-cells makes it harder for the body to control tuberculosis bacteria upon entry, increasing the risk of latent tuberculosis reactivation. This is a condition where bacteria silently exist in the body for many years before developing into active disease.

A healthy immune system can suppress tuberculosis bacteria for extended periods. However, as individuals age, this protective barrier weakens, creating an environment conducive for the bacteria to grow and cause overt disease.

High prevalence of underlying medical conditions

Many older adults suffer from chronic conditions such as diabetes, chronic obstructive pulmonary disease (COPD), bronchiectasis, cardiovascular disease, or cancer. These conditions reduce overall resistance and impair respiratory function, making the body more vulnerable to infections.

Certain medications used to treat chronic diseases, such as corticosteroids or immunosuppressants, can further diminish the body's protective capabilities. The combined effect of underlying conditions, ongoing medical treatments, and age-related immune decline significantly raises the risk of tuberculosis in this demographic.

Doctor Do examines a patient. Illustration: Tam Anh General Hospital

Malnutrition and weakened physical state

Malnutrition is common in the elderly due to poor appetite, reduced nutrient absorption, or co-existing chronic illnesses. A deficiency in protein, vitamins, and minerals impairs the production of antibodies and immune cells, making the body more susceptible to bacterial attacks.

A frail physical condition and reduced muscle mass diminish the body's ability to fight off and recover from illness compared to younger individuals. In communal care settings, crowded living conditions combined with weakened resistance further increase the risk of tuberculosis transmission if not rigorously controlled.

Age-related changes in lung structure and function

Over time, the lungs lose elasticity, respiratory muscles weaken, and the cough reflex becomes less effective. Reduced clearance of secretions allows bacteria to accumulate and thrive in the airways. This decline in respiratory function makes older adults more prone to respiratory failure as lung damage progresses, leading to a more severe prognosis.

Doctor Do advises older adults to seek medical attention if they experience persistent or unusual respiratory or systemic symptoms. Early screening for at-risk groups, strict adherence to prescribed treatment regimens, and close monitoring help limit complications, reduce the risk of transmission, and improve quality of life.

Thu Giang