Click to Subscribe for the MS Beacon eNewsletter, resources and MS education
By Quinn Phillips – Reviewed: May 4, 2023
Medically Reviewed by Michael R. Yochelson, MD, MBA
Activities like guided meditation may help to improve your cognitive abilities in the long term.
Tom Merton/Getty Images
From getting enough sleep to doing brain exercises, there are steps you can take to preserve and possibly improve your cognitive health.
If you have multiple sclerosis (MS), you’re probably aware of the wide range of symptoms that could develop over the course of your disease. Some, such as fatigue, spasticity, and walking difficulties, are well-known, whereas others, such as cognitive issues, are less commonly discussed.
Over half of all people with MS will develop problems with cognition at some point, according to the National Multiple Sclerosis Society. Usually, but not always, these changes are mild, and they don’t necessarily correspond to how severe your physical symptoms are. They can occur in anyone who has MS but are more common in people who have had the disease a long time.
As you might expect, cognitive changes are associated with the number and location of brain lesions seen on an MRI, as well as brain atrophy (shrinkage). These changes may become noticeable in different ways, such as:
- Trouble finding or remembering words
- Forgetting what to do in your home or work routine
- Trouble making decisions or judgments
- General difficulty with your job or school performance
There’s a widespread but mistaken belief that not much can be done about cognitive changes in MS. There are many things you can do to potentially improve your cognitive health.
Most of the actions you can take won’t interrupt or slow the disease process that’s contributing to your symptoms, but your brain is a complex organ that’s affected by numerous processes in your body, and changing any one of these can have an impact on your brain health.
Here are 10 steps you can take to preserve — or even improve — your brain health when you have MS.
1. Get Enough Sleep
Research shows that too little sleep is linked to worsening cognitive performance in people with MS, according to Meghan L. Beier, PhD, a neuropsychologist and assistant professor of physical medicine and rehabilitation at Johns Hopkins Medicine in Baltimore. “We know that people who get less than seven hours of sleep tend to have worse cognition,” she says.
A study published in March 2023 looked at 524 women with MS who were part of the much larger Nurses’ Health Study, a survey of more than 60,000 women on a range of health topics. The MS-focused report found a strong connection between cognitive impairment and sleep challenges like obstructive sleep apnea, insomnia, and sleepiness.
The research reflected the findings of an earlier study, from 2016, which looked at people with MS who slept poorly because of obstructive sleep apnea. That study found that less overall sleep and greater sleep fragmentation were both independently and significantly associated with deficits in visual and verbal memory, attention, executive function (the ability to plan and focus on tasks), and processing speed, accounting for 27 and 18 percent of the measured cognitive changes, respectively.
2. Work to Manage Fatigue
Fatigue can be a major factor in worsened cognitive performance in people with MS, according to Dr. Beier. “Fatigue management is really helpful,” she says. “We also know that things in the environment can have an effect on cognition, like heat. So when you’re doing something cognitively taxing, try to be in an environment that’s going to help cognition,” such as somewhere cool and relaxing.
Generally speaking, Beier says, fatigue management means planning out your days so that you don’t need to do anything physically or mentally demanding when you’re most likely to be exhausted.
3. Get Enough Physical Exercise
The right kind of exercise can help your brain function at its best, especially executive functioning, Beier notes. Some studies suggest that doing something cognitively challenging while exercising — having an in-depth conversation, doing math problems — enhances the benefits.
In a study published in 2018, researchers compared a high-intensity interval training program with a standard exercise program in 60 participants with MS. While both groups saw improvement in executive functioning, such as the ability to plan and prioritize tasks, the group that did interval training also saw improvements in their verbal memory.
4. Take Your Medication
Click here to continue reading this article direct from Everyday Health
Visit our MS Learning Channel on YouTube: http://www.youtube.com/msviewsandnews
