[Tuberculosis annual report 2009 --Series 4. Elderly TB].

In 2009 the tuberculosis (TB) incidence rates of the elderly population aged 65-74, 75-84 and 85 or older were 26.5, 63.4 and 98.1 per 100,000 in Japan, respectively. The TB incidence rate of those aged 65-79 showed a substantial decrease compared to 2000, with the rate decrease of those aged 85 or older being less pronounced. The proportion of TB cases aged 65 or older among all TB patients increased 1.6 times to 58.0% in 2009 from 36.8% in 1987; in particular, the proportion of those aged 80 or older increased 3.6 times to 28.8% from 7.9% in 1987. The proportion of elderly TB cases showed substantial differences between prefectures. The proportion of extra-pulmonary TB among elderly female TB patients aged 65-74 was 34.3% (22.4% for female TB patients aged 15-64). The proportion of bacillary TB among elderly pulmonary TB (PTB) patients was larger than that of young patients, but the proportion of cavitary PTB among elderly PTB patients was smaller than that of young PTB patients. The proportion of TB patients whose cases did not include respiratory symptoms increased with age. Among this group, the proportions of those aged 65-74, 75-84 and 85 or older were 15.9%, 21.3% and 22.7%, respectively. The elderly TB "patient's delay" was shorter than young TB "patient's delay", although the "doctor's delay" for elderly TB patients was longer than that for young TB patients. Most TB patients including elderly TB patients were detected upon their visit to a medical institution with some symptoms; in the case of elderly TB, more patients were detected as outpatients or inpatients for diseases other than TB. The prognosis of newly notified TB patients in 2008 was followed up until the end of 2009. Among TB patients aged 65 or older, 27.6% died within one year and 15.5% died within 3 months. The proportion of death showed a substantial increase with age; the increase was particularly accelerated among those aged 75 years or older.