Elderly Lyme disease patients more likely to have unfavorable treatment outcome


There have been limited studies investigating the impact of age on the clinical course and treatment outcome for Lyme disease. Now, a European study by Borsic and colleagues examines whether age is associated with treatment response.

The authors reviewed the records of 1,220 young, middle-aged and elderly patients, comparing disease course and long-term outcomes for each group.

The patients had been treated at an outpatient clinic at the University Medical Center Ljubljana in Slovenia. The study included 224 elderly patients, with 173 between 65-74 years old, 48 between 75-84 years old and 3 patients who were 85 years or older.

Patients with an erythema migrans (EM) rash were treated up to 14 days with doxycycline, amoxicillin, or cefuroxime. Individuals with multiple EM rashes were prescribed a 14-day course of intravenous ceftriaxone or doxycycline.

The outcomes for elderly patients were compared to those for middle-aged (ages 45-66) and young subjects (ages 18-44).

elderlyThe authors found that “older patients had slower resolution of EM and higher odds for an unfavorable outcome of treatment.”

At the 12-month follow-up visit, 7.8% of elderly patients had an incomplete treatment response, compared to 6.6% for middle-aged patients (n=627) and 3.7% (n=369) for younger patients.

“Up until now, information on the impact of age on the clinical course and outcome of early [Lyme borreliosis] was limited to one report from the U.S.,” the authors state.

This study found that the odds for an incomplete response was not only higher for older patients but also for women, patients with multiple EM, and for those who presented with [Lyme borreliosis]-associated constitutional symptoms, they say.

None of the elderly subjects with post-Lyme borreliosis symptoms met the criteria for “post-Lyme disease syndrome” because their reported symptoms did not necessitate a reduction of their previous activity levels.

In other words, the elderly subjects with “post-Lyme disease” were ill but could still function.

  1. Borsic K, Blagus R, Cerar T, Strle F, Stupica D. Clinical Course, Serologic Response, and Long-Term Outcome in Elderly Patients with Early Lyme Borreliosis. J Clin Med. 2018;7(12).

8 Replies to "Elderly Lyme disease patients more likely to have unfavorable treatment outcome"

  • Donna Deane
    12/28/2023 (1:28 pm)

    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?!

  • John
    01/26/2023 (8:13 pm)

    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.

  • Robie wiesner
    05/28/2022 (7:41 am)

    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.

  • Larry Rotkin
    08/25/2020 (5:43 pm)

    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).

    • Dr. Daniel Cameron
      08/27/2020 (8:43 am)

      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.

  • Kathleen Pelley
    01/06/2019 (2:47 am)

    I am in my mid seventies. I was diagnosed when I was about 64. I am still struggling with problems probably connected to Lyme.

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