Multiple sclerosis (MS) often causes cognitive symptoms such as problems with memory and executive function — the mental skills you use to control behaviors and get things done. Forgetting simple things and being unable to follow directions can make daily life a challenge. Additionally, MS may slow down your brain’s processing speed.
Cognitive problems occur in 40 percent to 65 percent of individuals with MS and typically cause impairments in attention, information processing speed, and memory. If you’re concerned about your cognitive abilities, talk to your doctor about cognitive testing.
If you’re experiencing memory loss, slowed thinking, or other issues with cognitive function, there are several strategies you can use to improve your functioning. Some are quick tips you can use today, while others may take time. Because MS is usually a lifelong condition, it’s good to think long term about ways to improve and preserve your cognitive abilities.
If you’re having problems with memory function, these tips may help:
“Cognitive reserve” refers to the brain’s ability to adapt, improvise, and be flexible. Keeping your brain stimulated and enriched can increase your cognitive reserve and help reduce the impact of MS-related changes in the brain.
Researchers have found that reading challenging materials can help improve skills in learning, memory, language, and problem-solving. There has also been interest in the use of video games to help people with MS. For instance, some researchers have focused on the use of the Nintendo Wii game system to help with multiple aspects of MS, including reducing falls.
Importantly, these video games have also been shown to help with cognition. One study found that Dr Kawashima’s Brain Training from Nintendo improved executive functions such as information processing speed and cognitive fatigue. In this study, participants were required to play 30 minutes per day, five days a week, for eight consecutive weeks.
MyMSTeam members have discussed the best brain exercises to improve cognition and retain memory. One member asked if anyone had tried Luminosity, a brain-training program that uses web and mobile games to challenge core cognitive abilities. “I feel like my brain keeps skipping, and I’m looking for brain exercises that might help,” they wrote.
Another member replied that they used to use Luminosity often and that they had noticed it helped with brain fog. Other community members have found that Luminosity, card games, crosswords, and sudoku help improve their cognitive performance.
Regular exercise may also affect the cognitive changes that can come with MS. Physical activity can reverse some of the condition’s effects on the body. For example, MS leads to damage to the brain and nerve cells, but research shows that exercise helps neurons (brain cells) regenerate and reorganize.
Exercise can help brain health by increasing levels of a chemical known as brain-derived neurotrophic factor (BDNF). BDNF is helpful in learning and remembering. Studies support the idea of using exercise to raise BDNF levels.
In one study from the Journal of the Neurological Sciences, individuals with MS were found to have lower levels of BDNF in their blood compared to individuals without MS. After aerobic exercise, these BDNF levels increased.
Additionally, physical activity may help improve blood flow in the brain, reduce MS symptoms, change brain activity, and slow progression of the disease. When people with MS increase their fitness levels, they may also have better executive function and cognition.
However, some MyMSTeam members disagree on whether exercise reduces or increases their fatigue. One member warned against overdoing exercise to reap the cognitive benefits while avoiding negative effects like fatigue. “Gentle and steady does it!” they said.
Adults need between seven and nine hours of sleep every night, but many people with MS have trouble getting that much. Sleep disturbances negatively affect cognition and memory, as they’re very common among people with MS. As many as 60 percent of people living with MS have sleep problems, and more than 13,000 MyMSTeam members report insomnia as a symptom.
Try to prioritize getting a good night’s sleep and taking naps as needed. It’s best to stick to healthy sleep practices, and if you suspect you may have signs of a sleep disorder, seek diagnosis and treatment.
As much as possible, leave your most challenging cognitive tasks for when your brain function is at its peak. For instance, if you feel your sharpest in the morning, try to use that time to learn new information, make difficult decisions, or have complex conversations. If there’s a time when your brain is at its foggiest, try to avoid tackling tricky cognitive tasks during this period.
Keeping an MS symptom journal may help you pinpoint when your cognition will be at its worst. Rather than a time of day, some people find their brain fog is the worst based on when it’s time for their next MS treatment. “I feel I can tell when infusion time is near,” shared one member. “I think foggier and feel shaky.”
Some days are just off, and MyMSTeam members often recommend informing those around you and putting off anything that requires a great deal of thinking.
“Brain fog happens,” wrote one member. “When it strikes, I don’t sign anything, don’t drive, and I usually just make it a day where I either catch up on shows or crotchet ’cause I won’t trust myself. I have run my glasses through the dryer and dishwasher on days where things aren’t so clear.” Another added, “Some days are so bad I forget how to do basic things. I just let everyone know as well. Remember to be easy on yourself.”
Cognitive rehabilitation is another method for boosting cognitive abilities. Cognitive rehabilitation therapy is mental training that helps keep cognitive abilities sharp. If you have MS, training that improves cognitive function can significantly improve your life.
This training encompasses two types: restorative and compensatory. Restorative cognitive rehabilitation attempts to restore cognitive faculties that have been lost, while compensatory cognitive rehabilitation teaches strategies that compensate for cognitive impairment. Therapists generally use both types to help people with MS.
An example of restorative cognitive rehabilitation is when a person performs increasingly difficult memory tests to improve their memory or undergoes training to improve their attention span. An example of compensatory cognitive rehabilitation includes using calendars to help keep track of tasks and events.
Although there have been some difficulties in studying the effectiveness of cognitive rehabilitation therapy (mostly due to differences in study methods used), research seems to support that this type of therapy can improve attention, executive functions, and memory.
Cognitive behavioral therapy (CBT) is a type of psychological treatment. It focuses on changing unhelpful thoughts and behaviors, improving emotional self-control, and developing coping strategies for stress and other challenges. CBT can help treat many conditions, including:
Evidence from the Journal of Clinical Neuroscience suggests CBT can also help improve certain aspects of cognitive dysfunction.
People with MS commonly experience fatigue, which can affect their physical, mental, and social quality of life. However, studies have shown that CBT can help treat fatigue-related symptoms in people with MS. For example, CBT may be able to help improve attention in people with MS.
MyMSTeam is the social network for people with multiple sclerosis and their loved ones. On MyMSTeam, more than 195,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.
Have you found effective ways to manage memory problems or improve cognitive issues with MS? Share your experience in the comments below, or start a conversation by posting on your Activities page.