V. Cognitive impairment in Lyme disease: specific functions and the impact of deficits
1. Attention and mental tracking. Includes directed and sustained attention: the ability to direct and maintain one's focus on a particular event or idea, whether in the environment or internally; and divided attention: the ability to simultaneously attend to two events, or do two or more things at a time, or to retain awareness of one thing while doing another.
Impact: difficulty functioning effectively in many situations, remembering what one was doing before a distraction, keeping track of conversation, taking notes while someone is speaking, remembering that someone is on hold, or what you were about to say.
2. Memory: Retaining new information.
Impact: secondary to impaired attention, slowing of processing and the retrieval of stored information, but not storage per se; a tendency to lose or forget things; miss appointments; repeat oneself.
3. Receptive language: understanding spoken or written language
Impact: secondary to impaired attention and speed of processing; difficulty participating in meetings or social conversation; difficulty with reading comprehension.
4. Expressive language: Using spoken or written language to express ideas
Impact: difficulty finding the right word; using the wrong word and not noticing; not being able to express oneself or communicate.
5. Visuospatial Processing: Efficient scanning of the visual field, making sense of how things are related in space; visuospatial conceptualization and problem solving.
Impact: a tendency to get lost; difficulty with reading comprehension.
6. Abstract reasoning: The ability to generalize from the particular; to identify the common factor between related concepts; to compare and contrast two things or ideas; to see the "big picture"; to identify the critical factor in a situation; to anticipate consequences and make inferences regarding cause and effect.
Impact: difficulty with decision making, planning, and problem solving.
7. Speed of mental and motor processing: The ability to think and respond quickly; critical to understanding speech which occurs at a fairly constant rate.
Impact: difficulty understanding or keeping up a conversation; functioning in a timely manner in day to day situations; meeting deadlines.
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