Lyme Disease and Cognitive Disorders

Lyme disease is not tied with either Alzheimer's disease or Lewy body dementia, according to a recent study published in the Clinical Infectious Diseases.

Patients with Lyme disease often report disturbances to concentration or memory, and some patients report residual cognitive symptoms after treatment. The role that microorganisms might have in the development of Alzheimer's disease is a topic of considerable interest.

One study found that compared with control patients without Lyme disease, patients with untreated Lyme disease reported significantly more difficulty concentrating or memory problems (P =.004). Dementia occurring as a result of Lyme disease is reported more frequently in Europe due to the common causative bacteria in that geographic location. The best-documented cases for dementia from Lyme disease have clinical features that resemble normal pressure hydrocephalus with abnormal cerebrospinal fluid biochemistry. However, studies that used neurocognitive testing typically did not find significant cognitive deficits among patients with Lyme disease.

A recent, single-patient case report called into question whether Lyme disease may cause Lewy body dementia. The patient had early Lyme disease that had been treated with doxycycline, which is highly effective for Lyme neuroborreliosis. The patient had a multi-year gap between the treatment of the early Lyme disease and cognitive decline. No significant difference in B. burgdorferi sensu stricto detection in postmortem tissue samples was noted between the case patient and controls.

In this article, the researchers discuss whether there is credible evidence that Lyme disease is a cause of Alzheimer's disease and critically review a recent publication claiming that Borrelia burgdorferi sensu stricto infection, the primary cause of Lyme disease in the United States, may cause Lewy body dementia.

Thus, the researchers concluded that no convincing evidence exists that Lyme disease is a cause of either Alzheimer's disease or Lewy body dementia.

Reference

Wormser GP, Marques A, Pavia CS, Schwartz I, Feder HM Jr, Pachner AR. Lack of convincing evidence that Borrelia burgdorferi infection causes either Alzheimer's disease or Lewy body dementia published in the Clinical Infectious Diseases. Published online November 29, 2021. https://doi.org/10.1093/cid/ciab993