Geriatric tuberculosis (TB) is an emerging but under-recognized challenge in India. Older adults often present with atypical or advanced disease, leading to delayed diagnosis, treatment complications, and increased mortality. While pulmonary TB is common, extrapulmonary and disseminated forms are also frequent. Diagnosis is hindered by non-specific symptoms and reduced microbiological yield, and treatment is complicated by co-morbidity, polypharmacy, and poor adherence. Despite elevated risk, older adults are not prioritized under current TB preventive strategies. This review highlights the unique clinical features, diagnostic limitations, and management challenges of TB in older adults, emphasizing the need for age-responsive TB control strategies.
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