We know that thinking and memory can be adversely affected by MS, but can we mitigate its effects?

Article by Dr Luke Smith

Dr Luke Smith, a clinical neuropsychologist with experience in supporting people with MS, discusses the factors that can contribute to a decline in cognitive functioning as well as practical strategies you can implement to improve your cognitive abilities right now.

Cognitive symptoms are not necessarily due to how much MS you have in your brain.

Even though we talk about the general symptoms of MS, everybody’s experience is different and what we know from the research is that when it comes to cognitive symptoms, it’s not necessarily how much MS you have in your brain but where it’s located. So for people who have MS in the parts of their brain that are responsible for thinking and memory abilities, there is obviously a risk that they might experience changes in their cognitive functioning.

It’s not just the location of your MS that can lead to difficulties in cognition.

It’s important to remember that other symptoms of MS can be a contributing factor. For example, if you have MS fatigue, it might affect your cognition. In fact, I have worked with people with MS who generally have no cognitive symptoms but if they are really fatigued, they will experience a temporary dip in their thinking and concentration skills. Also, mental health issues including depression and anxiety, and poor sleep, can all lead to an exacerbation of cognitive difficulties.

Difficulties in finding words and ideas while you’re talking to other people, which is a common complaint of people with MS, can be really frustrating because the words are often still there, it just takes longer to get them out. So, if you’re under time pressure or feel like you’re being rushed, it’s not going to help your ability to think and process.

Managing your thinking speed is about managing your timeframes, and this can be done both at home and at work.

At home – set a meeting date so your family or friends can sit down and talk about what they wish to discuss in a timeframe that works for you.

At work – try to avoid corridor conversations. If a colleague grabs you and asks if they can quickly talk to you about something, you can say something like, “I’m actually busy right now. Can I talk to you in 15 minutes?” or “can we find a meeting room?” Some people are uncomfortable disclosing it’s because of their MS, it’s your choice if you want to bring this up or not.

People with MS often complain of changes in their attention and concentration. If this is you, here are some things you can do to help mitigate this issue.

Give yourself breaks if you have difficulty with sustained attention – if you’re at work, put a timer on your phone to have a break every 30 minutes or so, or in a timeframe that works for you.

Try to concentrate on one thing and reduce distractions in your environment – if you have an important activity, job or discussion you need to concentrate on, you need to reduce your distractions. For example, turn off the TV and put your mobile on airplane mode when focusing on a task.

Research evidence supports cognitive rehabilitation for people living with MS

Using and learning cognitive strategies may not necessarily improve your score on a memory test, but they might improve your ability to remember and complete things in daily activities. The most important part is actually applying those cognitive strategies to specific activities in your life. There are many different strategies such as using a really good diary, calendar, or prompting system. Others involve testing your delayed recall (how much you can remember over a period of time), chunking is a really good strategy you can use. There’s also the ‘method of loci’ approach, where you use visual imagery to try and remember things.
Speak to a health professional about a strategy that’s right for you, based on an objective assessment of your thinking and memory skills.

It’s really important to recognise that MS can affect your thinking and memory.

Recognise your symptoms, have your thinking and memory assessed, find strategies to help. People who don’t seek assessment and support from health professionals can live with cognitive issues for a long time, which in turn detrimentally affects their life and causes stigma, such as others accusing them of being disorganised or disinterested.

If you would like further information, Dr Luke Smith can be contacted via his website: www.smithneuropsychology.com.

If you’d like to speak to someone about MS fatigue management strategies, call our MS Connect team on 1800 042 138.

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