The effect of fatigue on the cognitive status and quality of life of patients with Lyme- borreliosis

Abstract

The relevance of the issue of asthenic disorders is determined by a high prevalence among patients with various chronic pathologies and its impact on the disease course, treatment efficacy, and quality of life. The purpose of the study was to analyze the dependence of cognitive disorders and the quality of life of patients with Lyme borreliosis on the level of fatigue. Materials and Methods. The study involved 48 patients with Lyme borreliosis. The MOS 36-item Short Form Health Survey (SF-36) was used to study the quality of life of patients. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), and the impact of fatigue was evaluated using the Fatigue Severity Scale (FSS). Results. According to the results of assessing asthenia/fatigue severity (FSS), the prevalence of asthenic disorders in patients with Lyme borreliosis was 45.8%. Cognitive impairment with an MMSE score of <28 was found in 64.6% of patients, and the MoCA score of <26 was revealed in 56.2% of patients. Manifestations of moderate or severe fatigue were more common among women (OR 5.43; 95% CI [1,29-22,94]), patients with neuroborreliosis (OR 13.64; 95% CI [2,62-70,9]), patients with late-stage of disease (OR 9.23; 95% CI [2,46-34,58]), and those with a lower MMSE score (26.14±2.53 vs. 27.54±2.25 scores, р=0.048) and MoCA score (23.59±2.77 vs. 25.46±2.42 scores, р=0.016). Fatigue significantly reduces the quality of life of patients with Lyme-borreliosis, in particular: physical functioning (p=0.002), role physical and role emotional (p<0.001), bodily pain (p=0.037), vitality (p<0.001), social functioning (p=0.048). Conclusions. It was found that the presence of asthenia depends on the gender (female), the presence of clinical manifestations of damage to the nervous system (neuroborreliosis) and cognitive disorders, as well as the late stage of the disease. The presence of fatigue significantly reduces the quality of life of patients with Lyme borreliosis.