Cognition refers to memory and thinking. Multiple Sclerosis (MS) can affect any function of the body, and cognition is not an exception. Multiple Sclerosis affects memory and thinking in a person causing problems in performing daily tasks related to the brain. These tasks include, but are not limited to, reasoning, solving problems, remembering, focusing, and concentrating etc.

How many People Suffer from Cognitive Impairment?

In a 2012 research, Jongen, Ter Horst and Brands reported that 40-65% patients with MS faced cognitive dysfunction. The impairment typically involved information processing speed, complex attention, executive functions and the ability to remember things and events.

Studies have shown that 40% patients have mild impairment and only about 5-10% patients have moderate to severe dysfunction. What is mild impairment for one may be severe for the other and vice versa. It all depends on the person’s level of disease and circumstances.

Causes of Cognitive Impairment

The following have been identified as common causes of impairment in MS patients.

Lesions – Magnetic Resonance Imaging (MRI) studies have shown clear correlation – or relationship – between brain lesions and cognitive problems. Lesions are the areas of scarring. These areas are particularly common near the inner cavities of the brain called the ventricles.

Depression – Another factor responsible for causing cognitive impairment in MS patients is depression. The finding is backed by a vast multitude of studies which show a presence of strong relationship between depression and cognitive dysfunction. The problem may affect memory, learning, executive functioning and processing speed in the individual.

Depression is the cause of inflammation in the brain. It is natural to hypothesize that inflammation in the brain may induce depression. Neural degeneration and lesion development follow those swellings which lead to cognitive impairments. However, we advise to discuss with your neurologists before making such hypotheses.

One important thing to note here is that certain medications also cause depression which is a hallmark of Multiple Sclerosis. In both cases, patients should consult their neurologists.

It is very important to recognize cognitive changes early on. The impairments can have significantly negative effects on a person’s quality of life. The changes are also responsible for declining the persons performance at work, resulting in early departure from the workplace. The patient would rather prefer a stay-at-home job. Warning signs of cognitive dysfunction could be any one or more of these:

• Trouble remembering events
• Difficulty finding the right words
• Showing poor judgment
• Difficulty keeping up with tasks
• Trouble remembering what to do on the job or at home
• Difficulty making decisions
• Difficulty when concentrating and focusing attention for a longer period of time
• Difficulty in reasoning and solving problems
• Difficulty to plan, carry out and monitor own activities
• Difficulty when multitasking

If you find one or more of the above listed symptoms in you, contact your neurologist.

Treatment Options

The following two types of treatment are advised:

1. Pharmacological
Research has come to a conclusion that certain medicines are beneficial in treating cognitive dysfunction. Patients should consult a neurologist for those.

2. Non-Pharmacological
Also known as Cognitive Rehabilitation, this is designed to help people compensate for the loss of memory or slowed learning ability. A neurophysiologist, an occupational therapist, or a speech/language pathologist provides one or more sessions every week over a certain period which may last for several weeks to several months.

Tips To Alleviate Cognitive Problems

• Stay a mile’s away from stressful situations and negative thoughts
• Talk your concerns with your doctor
• If cognitive problems are hurting your self-esteem, it is a good idea to get counseling
• Keep a good smartphone and list your daily tasks so that you don’t forget them. A paper and pencil will also do the trick equally well

Multiple Sclerosis results in impairment of cognitive functions. Patients should consult their neurologists if a problem arises. MS patients need to stay away from stressful situations causing depression which worsens impairment.

Do you experience any of the symptoms mentioned above? How can you relate your condition when it comes to mental and cognitive problems? Share with us in the comments below.