Elderly Lyme Disease Patients More Likely to Have Unfavorable Treatment Outcomes
Older Lyme disease patients may have slower recovery and a higher risk of incomplete treatment response.
The authors reviewed 1,220 patients across age groups, comparing disease course and long-term outcomes. The study included 224 elderly patients treated at the University Medical Center Ljubljana in Slovenia.
Patients were grouped as young (18–44), middle-aged (45–66), and elderly (65+).
Treatment Approach
Patients with an erythema migrans (EM) rash were treated for up to 14 days with doxycycline, amoxicillin, or cefuroxime.
Those with multiple EM rashes received a 14-day course of intravenous ceftriaxone or doxycycline.
Slower Recovery in Elderly Patients
Older patients had slower resolution of erythema migrans and higher odds of an unfavorable outcome.
At 12 months:
- 7.8% of elderly patients had incomplete recovery
- 6.6% of middle-aged patients
- 3.7% of younger patients
Risk of incomplete response was also higher in women, patients with multiple EM rashes, and those with constitutional symptoms.
Persistent Symptoms in Older Adults
Some elderly patients reported ongoing symptoms after treatment but did not meet criteria for post-treatment Lyme disease syndrome (PTLDS), as their symptoms did not significantly limit daily activity.
For more, see persistent Lyme disease symptoms.
Clinical Perspective
This study highlights that age may influence recovery in Lyme disease.
Older adults may experience slower improvement and persistent symptoms despite standard treatment.
Clinicians should consider age, symptom burden, and clinical context when evaluating treatment response.
Clinical Takeaway
Elderly Lyme patients may recover more slowly and have higher risk of incomplete response.
Related Articles:
References:
- Borsic K, Blagus R, Cerar T, Strle F, Stupica D. Clinical course and outcomes in elderly Lyme patients. J Clin Med. 2018.
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
I am in my mid seventies. I was diagnosed when I was about 64. I am still struggling with problems probably connected to Lyme.
You are not alone.
My 89 year old mother in law was diagnosed with Lyme disease about 2-3 weeks ago. She has been taking doxycycline/Hiclate 100 mg since July 30th. She is not eating at all. Does anyone know how long she can go without eating.
Should we take her off the medicine? To compound the problem she also has medium Alzheimers (or more).
There are other antibiotics that are easier on the stomach. I typically advise a reassessment to reexamine the plan to include an assessment of the risk of weight loss.
I have had Lyme for 4 yrs. Severe neuropathy was resolved as well as all but gastro symptoms which are intense. I am 77 yrs old.
I’ve had Lyme’s symptoms and physical limitations for over 30 years. Although I enjoy walking daily, limitations are increasing. Taking herbal remedies for babesia but have to wonder if it’s worth it.
I have found Malarone or Mepron quite helpful.
Healthy early senior collapses goes to ER. Double Pneumonia. Enlarged Heart. Lung nodule.
Active Lyme. Four months later aching joints, headaches, bones, memory loss, declining in health. Repeat in pneumonia. Internist says old age. Arthritis. Of course you feel bad. Why can’t I get my husband’s dr to hear us here in VA? It’s Lyme! Help?!
I have had lyme for 6 yrs & only recently learned I have Bartonella & Babesia