In India, where respect for elders is deeply rooted in our culture, there’s one silent threat that too often goes unnoticed among them — Tuberculosis (TB).

While most public awareness around TB focuses on the young or working population, an alarming truth is emerging: older adults are becoming increasingly vulnerable to TB, and their diagnosis is often delayed or missed.

As India works toward the goal of TB Mukt Bharat by 2025, it’s vital that our fight includes this growing demographic — because protecting our seniors means protecting the wisdom, experience, and strength of our nation.

TB in the elderly: A hidden epidemic

Ageing brings many health challenges — weaker immunity, chronic illnesses, and reduced access to healthcare — all of which make the elderly more susceptible to TB.

According to the India TB Report 2024, nearly 18–20% of all TB notifications in India are among people aged above 60 years¹. This number is rising each year as India’s elderly population continues to grow.

The World Health Organization (WHO) also notes that older adults account for the majority of TB deaths globally, not because the disease is more aggressive in them, but because it is often detected too late².

Why seniors are at greater risk

TB in older adults doesn’t always look like typical TB. Many seniors don’t experience the classic symptoms such as a persistent cough or fever. Instead, they might show vague signs — fatigue, weight loss, loss of appetite, or confusion — which are often mistaken for ageing or other chronic illnesses like diabetes or COPD.

This makes diagnosis challenging, especially when the elderly also suffer from weakened immunity, diabetes, kidney disorders, or malnutrition — all of which increase TB susceptibility³.
Additionally, social isolation and limited mobility mean that older adults may delay seeking care or be unable to reach testing facilities.

The overlooked barriers: Why TB in seniors often goes undetected

Despite India’s robust TB elimination efforts, older adults remain a blind spot in the system. Several factors contribute to this:

• Atypical symptoms: TB in the elderly often lacks classic signs like cough or fever.
• Co-existing diseases: Conditions such as diabetes, COPD, or heart disease can mask TB symptoms.
• Delayed diagnosis: Many seniors live alone or depend on family members who may overlook early warning signs.
• Stigma and neglect: Some elders hesitate to disclose symptoms due to fear of isolation or being a burden.

According to the Indian Council of Medical Research (ICMR), older TB patients have a 2–3 times higher risk of delayed diagnosis compared to younger adults⁴. This delay not only worsens health outcomes but also increases the risk of transmission within households and old-age homes. In fact, the ICMR-TB surveillance study (2023) found that mortality rates from TB are nearly 1.8 times higher in people aged 60 and above compared to younger adults⁵.

This is not merely a medical issue — it’s a social challenge that demands empathy, tailored care, and targeted awareness.

Diagnosis and treatment: Same disease, different needs

The good news? TB in the elderly is completely curable, provided it is diagnosed early and treated correctly. However, the approach must be adapted to meet their unique physical and emotional needs.

Diagnosis

• The National TB Elimination Programme (NTEP) recommends active case finding among elderly populations — especially in high-burden areas such as slums and senior care centres⁶.
• GeneXpert testing and mobile TB vans are helping identify cases faster in rural and urban communities alike.
• Healthcare workers are also being trained to recognize non-classical TB symptoms in older adults.

Treatment

• TB treatment for seniors follows the same standard regimen — but doctors must carefully manage drug interactions with medications for diabetes, hypertension, or heart disease.

• Home-based follow-up visits, telemedicine, and elder-care NGOs are being encouraged to monitor adherence and side effects.

Nutrition and emotional care: The twin pillars of recovery

Older adults fighting TB often face social isolation and loss of appetite, making nutrition and emotional support just as vital as medicines. A diet rich in protein (milk, pulses, eggs), vitamins (fruits, green vegetables), and micronutrients (iron, calcium, zinc) helps boost recovery.

The National Family Health Survey (NFHS-5) revealed that over 35% of India’s elderly population suffers from undernutrition⁸ — a factor that slows healing and weakens treatment response.

Equally important is emotional wellbeing. Family involvement, encouragement from caregivers, and regular health check-ins can make a world of difference in a senior’s recovery journey.

Community-based care: Bringing TB services closer to the elderly

India’s public health system is shifting from hospital-based to community-based TB care, ensuring that older adults do not fall through the cracks.

• ASHA workers and ANMs now play a major role in doorstep TB screening and follow-ups.
• The “Pradhan Mantri TB Mukt Bharat Abhiyaan” is empowering local volunteers, or Ni-kshay Mitras, to adopt TB patients and provide nutritional and psychological support.
• Digital tools like Ni-kshay portal ensure real-time monitoring of treatment adherence and outcomes among elderly patients.

These measures, when combined with family and community involvement, help older patients stay connected, supported, and hopeful throughout their treatment.

Quick facts: TB in India’s elderly

Nearly 1 in 5 TB cases in India occur in seniors¹
Elderly TB mortality is 1.8x higher than in younger adults⁵
GeneXpert and mobile vans improving elderly TB detection⁶
Early diagnosis + family care = faster recovery

Towards age-inclusive TB care

India’s battle against TB cannot be won without addressing the special needs of its elderly population. As the country’s senior citizen base crosses 150 million by 2030, age-inclusive TB policies will play a defining role in achieving TB Mukt Bharat.

What we need now is not just medical intervention — but compassion-driven innovation. Here’s what can make the difference:

• Dedicated elderly TB screening camps at community and geriatric centres.
• Integrated TB–NCD (non-communicable disease) care, since diabetes and heart disease raise TB risk.
• Training caregivers and families to spot early TB symptoms in the elderly.
• Home-based DOTS (Directly Observed Treatment) and teleconsultation support for those unable to travel.
• Stronger social security linkages for older TB survivors.

As the WHO End TB Strategy highlights, equitable healthcare must “leave no one behind — especially the vulnerable and the aged” ⁹. India’s National TB Elimination Programme is now moving toward this inclusivity by integrating elderly care into its surveillance, awareness, and community support systems.

A call to protect our elders

Behind every elderly TB patient is a lifetime of stories, experiences, and contributions to family and society. They deserve not only treatment but dignity, compassion, and continuous care.

With greater awareness, proactive screening, and community-driven support, we can ensure that no senior suffers in silence from a curable disease. Because every life — young or old — deserves the chance to breathe free.

Key Takeaways

• TB in the elderly is rising but curable with early diagnosis.
• Non-classical symptoms often delay detection — vigilance is key.
• Nutritional and emotional support are as vital as medication.
• Home-based and community TB care empower older adults.
• Family involvement ensures adherence and lasting recovery.

This is an educational initiative supported by Mylan Pharmaceuticals Private Limited (a Viatris company).

References:

1. Central TB Division, MoHFW. India TB Report 2024. https://tbcindia.mohfw.gov.in/
2. World Health Organization (WHO). Global Tuberculosis Report 2023. https://www.who.int/publications/i/item/9789240078467
3. National Health Mission (NHM). Tuberculosis and Elderly Health Overview. https://nhm.gov.in/
4. Indian Council of Medical Research (ICMR). Challenges in TB Diagnosis among the Elderly. https://main.icmr.nic.in/
5. ICMR TB Surveillance Study 2023. TB Mortality and Age Correlation in India. https://tbcindia.gov.in/
6. National TB Elimination Programme (NTEP). Active Case Finding Guidelines. https://tbcindia.mohfw.gov.in/
7. MoHFW. Ni-kshay Poshan Yojana. https://tbcindia.gov.in/
8. National Family Health Survey (NFHS-5). Elderly Nutrition and Health Indicators. http://rchiips.org/nfhs/
9. World Health Organization. End TB Strategy Framework. https://www.who.int/teams/global-tuberculosis-programme