Assessment of the prevalence and clinical features of cognitive disorders among patients with Lyme disease depending on the stage and clinical manifestation of the disease

Abstract

Annotation. Lyme disease is the most frequent disease among naturally occurring zoonoses. The first cases of tick-borne borreliosis in Ukraine were confirmed in 1994. The disease has been officially registered since 2000. Despite the high prevalence of cognitive and neuropsychological disorders in Lyme borreliosis, data on their frequency and degree of severity are contradictory. The examination of cognitive status is still not included in the standard clinical examination of this category of patients. The purpose of the study is to assess the prevalence and severity of cognitive disorders among patients with Lyme disease depending on the clinical features of the disease. We conducted a case-control study. Thirty-eight (29 women, 9 men) patients aged from 23 to 77 years (average - 48.58±16.81 years) were examined. For each patient, 38 controls matched by gender, age (±5 years), nationality, and place of birth were selected. Mini-Mental Scale Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. All obtained data were processed by methods of variational statistics using the statistical package "SPSS 20" (SPSS Inc.) version 21.0.0 for Windows using the Shapiro-Wilk test. Data are presented as M±σ or Me [Q25-Q75]. Depending on the needs, Student's t-test, Mann-Whitney test were used, χ2 (Pearson) and odds ratio (OR), 95% confidence interval (CI), linear correlation coefficient (r) were determined. Lyme disease was associated with a more than threefold increase in the risk of developing cognitive impairment (OR 3.59; 95% CI [1.27-10.14]). Seven patients (18.4%) suffered from mild, 15 (39.5%) had moderate cognitive impairment, and 9 (23.7%) patients were diagnosed with mild dementia. Cognitive disorders were significantly more common in patients with neuroborreliosis (OR 12.44; 95% CI [1.84-84.26]) and the late stage of the disease (OR 6.11; 95% CI [1.1-37.49]). The severity of cognitive impairment according to the MMSE was negatively correlated with the age of onset (r = -0.631, p<0.001) and the duration of the disease (r = -0.406, p=0.011). Prospects for further research are to study and analyze the correlations of cognitive and psychoemotional disorders in patients with various manifestations of Lyme disease.