It’s common for people living with multiple sclerosis (MS) to wonder about their risk of developing other diseases that affect the brain, especially dementia — a slow and steady decrease in thinking skills, memory, and social abilities. Symptoms of dementia can overlap with some of the cognitive problems associated with MS, so it’s normal to have questions about a possible connection.

MS is an autoimmune disease that attacks the brain and spinal cord, causing neurological symptoms that may include cognitive difficulties. Experiencing memory impairment or another symptom that could potentially suggest dementia can be scary. One member of MyMSTeam shared, “I forget words, and I’m hesitant to talk for fear of embarrassing myself. I’m also afraid someone will think I have some form of dementia.”

Having memory loss doesn’t necessarily mean you have dementia. Read on to learn more about possible connections — and differences — between dementia and MS.

What Is Dementia?

The word “dementia” refers to a broad category of symptoms that affect thinking, memory, and social interactions that are severe enough to affect your daily life. It’s important to know that dementia itself is not a disease. Of the many conditions that can cause dementia, including Alzheimer’s disease and Parkinson’s disease. Other types of dementia include Lewy body, frontotemporal, and vascular.

Typical symptoms of dementia include memory loss or difficulty with one or more of the following:

• Communication or finding the right words
• Visual-spatial tasks, such as getting lost in your own neighborhood
• Problem-solving
• Planning and organizing
• Coordination and motor function
• Orientation, such as being confused about the time or day or your location
• Decision-making

Sometimes, psychological symptoms are a part of dementia. These can include:

• Personality changes
• Socially inappropriate behavior
• Agitation
• Depression or anxiety
• Paranoid behavior
• Hallucinations

Often, these symptoms, along with memory problems, are first noticed by a family member or caregiver.

Symptoms of memory loss may be reversible, depending on their cause.

Dementia vs. Alzheimer’s Disease

In older adults, dementia usually results from Alzheimer’s disease, which is a brain disease. In this condition, proteins called beta-amyloid and tau build up in the brain, causing abnormalities that get worse over time. Eventually, the brain shrinks and brain cells die.

Alzheimer’s disease causes the progressive symptoms of dementia. Additionally, dementia typically affects older adults — more than 70 percent of people who have Alzheimer’s are 75 or older, according to Mayo Clinic.

Memory loss is the hallmark of Alzheimer’s disease. Over time, this defining symptom worsens, and typically a loved one will notice the change. Other symptoms of dementia also may appear.

Cognitive Symptoms in MS

Cognitive symptoms — those affecting learning, memory, and reasoning — are aspects of MS that were first described in the medical community in 1849. Studies have shown that about 65 percent of people living with MS experience some aspect of cognitive impairment. It’s thought that these cognitive impairments usually involve memory problems, slowed information processing, difficulty with attention, and sometimes challenges with visual and spatial awareness.

Neurology research has shown that the length of time a person has had MS isn’t a reliable indicator of having cognitive losses. Also, severity of cognitive deficits doesn’t seem to be related to the severity of physical symptoms or physical disability, and lesions aren’t present on MRI scans of white matter in the brain. Secondary progressive MS (SPMS) — a subtype of MS — seems to be associated more closely with declining cognitive function than other types of MS.

Cognitive Symptoms of MS vs. Dementia

Some people living with MS experience mild cognitive impairment known as brain fog, and others may meet the criteria to be diagnosed with dementia. But the main difference between the cognitive symptoms of MS and apparent dementia is how severe the symptoms are. Even though a substantial percentage of people with MS have cognitive impairment, this symptom tends to be on the mild side and to involve difficulties with remembering information and maintaining attention on a task.

That said, the cognitive symptoms of MS have high variability and sometimes can greatly affect daily living and quality of life. It’s important to keep in mind that aging, fatigue, and depression — often associated with MS and some medications — can also result in cognitive deficits.

Does MS Increase the Risk of Alzheimer’s?

Findings from a 2022 study suggest that people with MS are at increased risk of Alzheimer’s dementia at both younger (45 to 64) and older (65 and up) ages. Because Alzheimer’s is diagnosed without any lab test, no current data is solid. More studies on the association between the two diseases must be done with better diagnostic tools.

It’s also possible to have both MS and another disease that causes dementia. One prevalence study found that in one clinic, 22 percent of people with MS qualified as having possible dementia. Their cognitive impairments consisted mostly of memory problems and slowed thinking. When Alzheimer’s disease causes dementia in a person with MS, the impairment is usually severe.

Treatment for Cognitive Symptoms

A number of medications are available to treat certain types of dementia, but none have been shown to be successful in treating MS-related cognitive symptoms. Cognitive rehabilitation — an intervention to improve skills like thinking and memory with practice — has had mixed results in MS. Yoga has been shown to improve MS-related fatigue, which can be a cause of cognitive dysfunction in MS.

When To Talk to Your Doctor

If you or your loved one has new problems with memory or other dementia symptoms, check with your primary care doctor or neurologist as soon as possible. Sometimes it can feel embarrassing to tell your doctor about new difficulties with memory or performing daily activities, but it’s important to be honest about them. Some causes of memory loss are reversible, so getting a proper diagnosis and treatment quickly is important.

If your doctor is concerned about the cognitive problems that resemble dementia, they may order blood tests, imaging of your brain, and possibly neuropsychological testing to determine the right diagnosis and treatment plan.

Tips for Keeping Your Brain Healthy

If you are living with MS, keeping your brain healthy is important no matter what your age. You can maintain an active mind and reduce certain risk factors related of cognitive decline by taking steps such as these:

• Regularly engage in exercise that’s doable for you.
• Get enough sleep.
• Follow a nutritious, balanced diet such as a Mediterranean-style eating pattern.
• Keep up connections with friends, loved ones, and others.
• Give your brain a workout by reading, doing puzzles, and playing games.
• Protect your brain health with regular blood pressure, blood sugar, and cholesterol checks.

Read more about strategies to improve memory.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 198,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Are you living with MS and worried about dementia? Do you have any favorite strategies to help keep your brain sharp? Share your experience in the comments below, or start a conversation by posting on your Activities page.