Multiple sclerosis (MS) and memory loss often occur together. The cognitive symptoms in MS are typically mild. However, people with MS might notice that they have trouble finding the right word or start forgetting steps in everyday tasks, such as putting detergent in the washing machine.
As many as 3 in 4 people with MS experience cognitive impairment, which is a decline in remembering things and processing thoughts. Sometimes, cognitive changes in MS may affect an individual’s ability to drive, manage money, or perform well at work.
The National Multiple Sclerosis Society (NMSS) recommends early screening and regular monitoring for cognitive changes in MS. Someone who has cognitive symptoms can take steps to manage the changes and minimize the effect on their memory.
In this article, we discuss the link between MS and memory loss in more detail. We also look at the treatment and management of MS-related cognitive changes.
MS is a chronic disease that affects the central nervous system (CNS). The CNS consists of the brain, spinal cord, and optic nerves.
In people with MS, the immune system damages a fatty substance called myelin that coats nerve fibers in the CNS.
This damage may disrupt communication between the brain and other parts of the body, potentially leading to symptoms such as muscle weakness or problems with balance and coordination.
People with MS typically first notice symptoms between the ages of 20 and 40 years. However, the course of the disease is different for each individual.
The NMSS notes that many people with MS have what is called a relapsing-remitting form of the disease. This type of MS involves periods during which a person’s symptoms get worse, or they develop new symptoms. These attacks are known as exacerbations or relapses. Between exacerbations, the symptoms subside, and the person enters a remission phase.
Cognitive impairments affect up to three-quarters of people with MS, who will find it harder to think clearly and quickly and to remember things easily.
A person with MS may notice the following changes to their everyday life:
- feeling as though their thinking has become slower
- struggling to find the right words when speaking
- forgetting aspects of daily tasks
- struggling to make simple decisions
- falling behind at school or work
- becoming easily confused by conversations
An individual with MS might notice these changes in themself, or a friend or family member may observe them.
Memory and thinking problems can be the first symptoms of MS. However, this is not always the case, and these symptoms can arise at any time during the course of the disease.
Experts recommend that healthcare professionals evaluate a person’s memory and thinking soon after they make an MS diagnosis and regularly thereafter.
In addition, individuals with MS should ask for a more in-depth evaluation under some circumstances, including:
- when the healthcare professional observes a decrease in memory and thinking ability
- when the person is struggling at work or school
- if the individual plans to apply for disability benefits due to cognitive problems
Strategies are available to help a person with MS manage cognitive changes. Simple steps that an individual can take to help with memory problems include:
- using a calendar or computer app to keep track of appointments
- doing one thing at a time rather than trying to multitask
- assigning a specific spot to keep important items, such as keys, cell phones, and to-do lists
- establishing a fixed routine
- posting reminders around the house using “sticky” notes
The Multiple Sclerosis Association of America suggests wearing a garment with big pockets, such as a gardening apron, while at home. A person can use the pockets to store essentials, such as their reminder notebook, eyeglasses, and cell phone, as they go about their daily tasks.
In some cases, a doctor might recommend cognitive rehabilitation for a person with MS. During this type of therapy, the individual will learn exercises that they can practice to boost their memory and thinking ability.
Some evidence suggests that exercise might also improve thinking ability in people with MS.
The Multiple Sclerosis Trust in the United Kingdom states that there is currently not enough research to say whether a particular drug can help with MS-related memory and thinking problems.
However, some medications may make cognitive impairment worse. For example, drugs that treat overactive bladder may decrease thinking and memory abilities with long-term use.
Certain conditions, some of which can occur with MS, may also make cognitive symptoms worse. These include:
Treating any such underlying conditions may help prevent cognitive symptoms.
Everyone with MS may also benefit from adopting certain lifestyle measures, such as:
- practicing good sleep hygiene
- using stress management techniques, such as mindfulness
- maintaining a healthy social life
- making certain dietary changes
In addition to cognitive problems, MS has a wide range of other possible symptoms. These include:
- difficulty walking
- bladder conditions
- bowel dysfunction
- vision problems
- sexual dysfunction
Even though thinking and memory problems are common in people with MS, healthcare professionals often do not screen for cognitive symptoms or provide treatment.
Cognitive symptoms may affect personal relationships, job performance, and quality of life for someone with MS.
An individual with MS should talk with their healthcare team about any cognitive changes that they are experiencing.