Lyme Disease in the Elderly: Higher Prevalence, Different Symptom Patterns
Lyme disease occurs in older adults
Rates may be higher than expected
Symptoms can differ from younger patients
Diagnosis still requires careful evaluation
Lyme disease in the elderly may be more common than expected—and may present differently than in younger patients. This study highlights how infection rates and symptom patterns can vary with age.
Study Overview
Researchers evaluated 1,454 patients referred to a Lyme disease center.
Of these:
- 255 patients (17.5%) were age 65 or older
- 45% were male
- Average age was 79 (range 65–87)
This confirms that Lyme disease is an important concern in older populations.
Higher Rates of Confirmed Lyme Disease
Among elderly patients:
- 33% had clinical Lyme borreliosis with positive serologic testing
By comparison:
- 18% of younger patients met similar criteria
This suggests Lyme disease may be more frequently identified in older adults referred for evaluation.
Positive serology was defined as:
- Equivocal or positive IgG ELISA
- Combined with equivocal or positive IgG immunoblot
For more, see Lyme test accuracy.
Disseminated Lyme Disease in Older Patients
Among elderly patients:
- 45 had disseminated Lyme disease
- 5 had evidence of active infection
This highlights the potential for more advanced disease at the time of evaluation.
Depression Less Common Than Expected
Interestingly, depressive symptoms were less common in older patients.
- 9.8% of elderly patients had depression
- 24.7% of patients aged 18–64 had depression
Depression was approximately half as common in older patients compared to younger individuals.
For more, see depression in Lyme disease patients.
What This Means Clinically
This study highlights several important considerations:
- Lyme disease occurs in older adults and should not be overlooked
- Rates of confirmed infection may be higher in referred elderly populations
- Symptom patterns—including depression—may differ by age
- Disseminated disease may be present at evaluation
Age-related differences may influence how Lyme disease presents and is recognized.
Why Diagnosis Can Be Challenging
In older patients, symptoms may overlap with other conditions such as:
- Cardiovascular disease
- Neurodegenerative disorders
- General age-related decline
This overlap can delay diagnosis or lead to misattribution of symptoms.
For more, see Lyme disease misdiagnosis.
Clinical Takeaway
Lyme disease in the elderly is not rare—and may present differently than in younger patients.
Higher rates of confirmed infection and differing symptom patterns highlight the need for careful evaluation.
Clinicians should consider Lyme disease in older patients with unexplained or persistent symptoms.
Related Reading
Reference
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
