Expert Support
Use it or lose it!
Learning to cope with cognitive change
It often starts with little things. You lose your keys – again! You forget appointments, have trouble concentrating at work or find yourself searching for words to finish a sentence. For most people, these small lapses may just be a sign of stress or fatigue. But, if you have MS, they may be the first subtle clues that MS is affecting your cognition. Cognitive problems are closely associated with MS and are often the source of frustrating misunderstandings that can complicate your life at work and at home.
Cognition affects personal relationships
Cognition refers to higher level brain functions, such as learning, remembering, planning, and problem-solving – the important skills that help us manage our busy lives. Up to 50% of people with MS have mild to moderate cognitive difficulties. Although symptoms are vague and may fluctuate from day to day, cognitive problems can cause pervasive changes that affect every aspect of family life.
“Family members may not understand that MS causes cognitive problems,” explains Dr. J.R. McKelvey, a neurologist specializing in behavioural and cognitive neurology. “It can be hard for someone to accept that their spouse’s brain is just not working as efficiently as it did before. People with MS may have difficulty processing and organizing information and may only be able to accomplish half as much in a day as they used to. The stress of trying to meet the unreasonable expectations of their family only makes the situation worse. Family members have to learn that there is more to living with MS than just coping with physical changes.”
Cognition influenced by many factors
While most cognitive problems are caused by lesions on the brain, the effect of other factors, such as fatigue, medications, lifestyle changes and emotional difficulties, can’t be ignored. As fatigue sets in, you may have more trouble following instructions or completing tasks. Medications for pain or spasticity may impair your ability to concentrate. If MS affects your mood control, you may find your anger levels rising when memory fails or simple tasks become frustratingly difficult. Cognitive difficulties also tend to increase during relapses – as a matter of fact, some people have relapses that affect only their cognitive abilities.
Use it or lose it
Even the mildest cognitive impairments may require changes in your daily habits and routines. “But”, notes Dr. McKelvey, “that’s not a sign that you’re becoming impaired. Cognitive changes are normal and expected in MS and there are strategies that will help you maintain a good quality of life.” When it comes to brain function, the ‘use it or lose it’ philosophy prevails. It’s important to stay active and engaged, even if you are no longer working or getting out as much as you used to. Try to keep up social contact with friends and family and consider a hobby to keep your mind occupied. Challenge yourself with games like Scrabble or do crossword puzzles in the local paper – find entertaining ways to give your brain a workout.
Getting enough rest is essential but don’t overdo it – too much sleep can have a detrimental effect on mental alertness. Research on aging indicates that exercise helps maintain cognitive health, so try to include a little physical activity in your daily routine. Regular exercise – even if it’s just a short walk or some gentle stretching – is good for your health and may be just what you need to keep those gray cells snappy.
To keep track of appointments and phone calls, use a notebook or planner and write down everything you need to do. Refer to it regularly and tick things off your list when they’re done. Posting notes in strategic places around the house will also help to jog your memory. Designate a special place for your keys, glasses or other important items and always put them back in the same spot. Building consistency into your routine helps with memory retrieval.
When your memory fails, stay calm and don’t panic. By keeping anxiety at bay, you’ll solve the problem more easily.
If cognitive problems are concerning you, talk to your doctor or neurologist. Discussing your problems is often the first step to getting constructive support. Over the past decade, there have been many developments in neuropsychological testing that may help your physician determine the exact nature and degree of your cognitive changes. Armed with this information, he or she may be able to develop more specific strategies to minimize the effect of these changes on your quality of life.
