Study: Lyme Disease Outcomes in Older Adults
A key pattern is age-related difference. Recovery from Lyme disease varies across age groups.
The authors reviewed the records of 1,220 patients treated at an outpatient clinic at the University Medical Center Ljubljana in Slovenia, comparing disease course and long-term outcomes in young, middle-aged, and elderly individuals.
The study included 224 elderly patients, including:
- 173 patients aged 65–74
- 48 patients aged 75–84
- 3 patients aged 85 and older
Patients were grouped as:
- Young (18–44)
- Middle-aged (45–66)
- Elderly (65+)
Patients with erythema migrans (EM) were treated for up to 14 days with doxycycline, amoxicillin, or cefuroxime. Those with multiple EM rashes received intravenous ceftriaxone or doxycycline.
A key pattern is slower recovery. Older patients had slower resolution of erythema migrans and higher odds of an unfavorable treatment outcome.
Higher Risk of Incomplete Recovery
A key pattern is persistent symptoms. Elderly patients were more likely to have incomplete recovery at follow-up.
At 12 months:
- 7.8% of elderly patients had incomplete response
- 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
- Patients with constitutional symptoms
The authors note that prior information on age-related outcomes in Lyme disease had been limited, making these findings particularly important.
Persistent Symptoms Without Full PTLDS
A key pattern is partial recovery. Some elderly patients continued to experience symptoms after treatment.
However, these patients did not meet criteria for post-treatment Lyme disease syndrome (PTLDS), as their symptoms did not significantly reduce their ability to carry out daily activities.
In other words, patients may still feel unwell—even while remaining functional.
Clinical Interpretation
A key pattern is expectation gap. Slower recovery in older adults may be misinterpreted as treatment failure.
These findings suggest that:
- Recovery may take longer in elderly patients
- Symptoms may persist even after standard treatment
- Age, symptom burden, and presentation affect outcomes
Understanding these patterns can help guide expectations and clinical decisions.
Related Articles:
Lyme disease mimics autoimmune disorder in elderly woman
References:
- 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).
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