Staying Sharp With MS

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Cognitive impairment doesn't have to slow you down. Here's how to deal with those MS symptoms that take a toll on your mental fitness.

By Jan SheehanMedically reviewed by Lindsey Marcellin, MD, MPH
More than 400,000 people in the United States are currently living with multiple sclerosis, according to the National MS Society. Of these people, about 50 percent of them will experience some sort of cognitive impairment. That’s because just as MS impairs the body, it can also affect the mind.But for most, cognitive impairment in MS is rarely severe or debilitating. “Only 5 to 10 percent of people with MS suffer cognitive impairment that is bad enough to significantly interfere with daily activities or their ability to take care of themselves in their home,” says William Sheremata, MD, professor emeritus of neurology at the University of Miami Miller School of Medicine in Florida.Nonetheless, it is important to understand the MS symptoms that could affect you mentally.Types of Cognitive Impairment ProblemsMS symptoms involving cognitive impairment may include:

• Short-term memory loss. This is the most common form of cognitive impairment. You draw a blank on a familiar phone number, forget whether you took your medication, or can’t recall why you left the living room to go into the kitchen.
• Mental fatigue. Cognitive impairment can cause “brain fog” or slow thinking. “In psychological tests, MS patients have been found to tire more quickly," says Dr. Sheremata, leading them to perform less well on tests of cognitive performance.
• Distractibility. You may have a hard time focusing on what you’re doing. Some MS patients with cognitive impairment issues are easily distracted by noise, such as the television or music. It’s also difficult for them to multi-task.
• Verbal fluency problems. You may have difficulty finding the right words in conversations or get lost in a middle of a sentence. However, people with MS are able to understand words they hear and read just as well as people without MS, says Sheremata.
• Impaired planning. People with this MS symptom can have trouble planning and organizing their day. Some research shows that up 40 percent of people with MS are less able to plan than people without MS.
• Complex problems. Mental MS symptoms can impact a patient’s ability to figure out a difficult problem. “You may feel overwhelmed if a problem is too complex and may not be able to come up with alternate solutions,” explains Sheremata. This can lead to poor judgment.

Diagnosing and Treating MS Cognitive ImpairmentCognitive impairment doesn’t have to interfere with your quality of life or prevent you from continuing to work. Recognizing any difficulties and taking steps to compensate can make a big difference. If you suspect some cognitive impairment, discuss these MS symptoms with your doctor. Since cognitive impairment in MS is usually fairly subtle, your doctor will want to make sure that MS is causing the cognitive impairment rather than aging, medication side effects, or depression. You may be referred to a neuropsychologist or speech pathologist for testing. Based on these findings, a variety of exercises and techniques may be recommended to help compensate for cognitive MS symptoms. Certain disease-modifying MS medications may also be helpful.
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