Do you experience problems with your memory or concentration? Have ‘Brain fog’, word finding difficulties or have difficultly processing information? You may be experiencing changes to your cognition due to your MS.
Cognitive problems in MS are the result of the nerve damage in the brain interrupting the transmission of the electrical messages, reducing the speed and accuracy of the information getting through e.g you know the word you want to say - it’s there in your brain but you can’t get it out as pathway (nerve) is damaged
Lots of people with MS report changes to their cognition. This can often be a hidden symptom but can impact upon your quality of life, relationships with others and emotional wellbeing.
Areas of cognition affected may include:
Memory – this is the most common cognitive change reported and can affect both learning of new information as well as accessing or retrieving information (memories) you already have. You might have difficulty remembering events or forget about plans.
Attention and concentration – difficulty remaining on one task, easily distracted, hard to follow a conversation, find your mind wanders and may feel like you have information overload.
Information processing – you may need longer to process and make sense of new information. You may have difficulty following a series of complex instructions especially if given quickly.
Visual processing – ‘ I feel clumsy’ ‘I can’t find my stuff’, difficulty following maps, judging distance and speed when driving, reading.
Verbal fluency – difficulty finding the word. This is also really common and is made worse by stress and anxiety, so trying to relax and not getting hung up on it helps.
Executive function – this is what helps us adapt/be flexible and to organise our thoughts and activities, prioritise, and manage our time efficiently. You may find it difficult to make decisions or change what you’re doing quickly. Others may notice changes before you do. Family and friends can help with talking through important decisions.
Changes to cognition can be affected by:
Fatigue - Try to pace yourself and take regular rests during the day. Plan and prioritise. Delegate tasks, use energy saving techniques. Complete cognitive tasks at point in day when less fatigued. See page on fatigue.
Stress or anxiety – Relaxation and mindfulness can help reduce stress – see page on ACT for further information.
Low mood – find things you enjoy, challenge your negative thoughts (ACT can help with this), use fatigue strategies as fatigue and mood are linked.
Sleep – try to get enough sleep, have a good sleep routine, have a pad and pen by bed to write down things if your brain won’t switch off.
Poor diet – if you don’t have enough (and the right type of) fuel in your body this can cause cognitive problems.
Alcohol – this affects the Central nervous system abd can worsen cognitive symptoms.
Exercise – regular exercise can help. It can also help to improve our mood and reduce stress which impacts on cognition.
Medication – including some common MS medications can impact upon cognition – speak to your MS nurse if you are concerned.
Infections - e.g UTI’s or other illnesses can worsen cognitive difficulties.
There are lots of useful strategies you can use to help manage cognitive changes. Some of these include:
- Ensure a quiet environment with minimal distractions – turn off the radio or TV when completing the task.
- Give yourself enough time.
- Focus on one task at a time.
- It’s easier to concentrate in an uncluttered environment.
- Have a schedule/routine for the day/week/month – use a planner if needed.
- Use of reminders – calendar, diary, white board, smart phone, Alexa, have a to-do list, shopping list.
- Keep things in the same place so you don’t lose them e.g. your keys.
- If you can’t find the right word you could try: taking a breath/pausing, describing the word, using a different word, visualise the word, run through the alphabet in your head to think of the first letter.
- Use of colour overlays when reading or using a blank piece of paper to cover the text and guide your reading.
- Break task down into smaller sections.
- Let family and friends know so they can support you if needed.
- Be kind to yourself.
Further information
MS trust – staying smart has a wealth of information about specific cognitive difficulties and things you can do to help. https://mstrust.org.uk/resources/staying-smart
https://mstrust.org.uk/life-ms/wellbeing/thinking-and-memory-problems
https://www.msif.org/about-ms/symptoms-of-ms/cognition-and-emotional-changes/