You, MS and the Mind: Overcoming Cognitive Challenges

When people think about multiple sclerosis (MS), they may not associate it with memory loss, difficulty concentrating or struggles with organization. But if you or someone close to you has MS, these can be troubling symptoms. 
It’s more common to think first about physical impairments, even though at least 65 percent of MS patients also have cognitive challenges, says advanced practice nurse Marie Namey.
In her practice, she specializes in caring for people with MS. She says the good news is that cognitive problems severe enough to interfere with a person’s daily living are rare. Only between 5 and 10 percent of those with MS develop severe cognitive impairment, the National Multiple Sclerosis Society reports.
“It’s not the Alzheimer’s type of cognitive problem,” Ms. Namey says. “You don’t forget your family members’ names or become unable to recognize them. It’s more like having trouble concentrating, especially when two things are happening at once. Or you may have slower thinking in general.”
Ms. Namey offers five tips for dealing with the cognitive impacts of MS:
1. Stick with prescribed medication. “People often think of taking disease-modifying medication to protect their ability to walk,” Ms. Namey says, “but there is additional benefit in protecting the person’s brain from cognitive changes.”
2. Get an assessment. If you’re experiencing cognitive difficulties, talk to your health care provider about  being evaluated by a neuropsychologist or occupational or speech-language therapist, Ms. Namey says. They can often provide coaching to improve organization, for instance, “like having one calendar where you keep things instead of a hundred sticky notes everywhere.”
3. Keep your mind active with puzzles and games. Choose mind-challenging activities like crossword puzzles, Sudoku or other games you enjoy. But don’t just work a puzzle, speak the answers out loud for additional stimulation.
“A lot of people struggle with the ‘tip of the tongue’ phenomenon,” Ms. Namey says. “Information goes in their brain, but they have trouble expressing it. If the question is ‘What is the capital of Ohio?’ then speak it out loud — ‘Columbus.’”
4. Ask friends and family for help. Ms. Namey hears from patients whose families attribute their memory and concentration difficulties to being stubborn or disinterested. She suggests that you explain what you’re going through and ask for their help, like eliminating distractions during conversation.
5. Go easy on yourself. Of course, blanking on a word can be incredibly frustrating. “If you can’t express the word, just describe what you’re trying to say,” Ms. Namey says. “Don’t get too focused on a particular word.”
— Brain and Spine Team, Cleveland Clinic