Diarrhoea in elderly people: Aetiology, and clinical characteristics

We examined the characteristics of elderly people attending the Dhaka Hospital of ICDDR,B. The hospital has a diarrhoeal disease surveillance system that enrols a 2% systematic sample of all patients visiting the hospital. We reviewed data of all patients enrolled into the surveillance system (n=13,782) over the period 1996-2001 to identify patients aged 60 y and above for inclusion into the current study (4% of all surveillance patients; n=478). V. cholerae O1 was the most common enteric pathogen isolated from faecal culture of the patients (20%), followed by ETEC (13%), Shigella (11%), V. cholerae O139 (10%), Campylobacter jejuni (5%), Salmonella (3%), EPEC ( 2%), rotavirus ( 4%), and E. histolytica ( 2%). The isolation rate of V. cholerae O139 and Shigella was higher among the elderly compared to adults (15-59 y of age, 10% vs 6%, and 11% vs 7% respectively; p<0.05 for both comparisons). Compared to 15-59-y-olds, a significantly higher proportion of the elderly had visible blood in stools (8% vs 5%), required short-stay ward admission (86% vs 82%) or referral (1% vs <1%) to a health facility. Early initiation of oral or i.v. rehydration therapy, prompt referral, and immediate clinical diagnosis for assessment of the need for antibiotic therapy might be beneficial for the elderly.