While most people are aware of the physical changes caused by multiple sclerosis, they may not realize it can affect how we think, process, and learn. We do know that more than half of all people with MS will develop problems with cognition, and those cognitive problems may even be your very first symptom of the disease.
The very first cognitive changes might show up as trouble finding the right words, difficulty remembering what to do on the job, or feeling overwhelmed by the usual load. Many report difficulty making decisions or using poor judgment, struggling keeping up with tasks or conversations, trouble with job performance and keeping up at home.
Certain functions are more likely to be affected than others. Those include:
- Information processing (dealing with information gathered by our senses)
- Memory (acquiring, retaining, and retrieving new information)
- Attention and concentration (particularly multi-tasking)
- Executive functions (planning and prioritizing)
- Visuospatial functions (visual perception and constructional abilities)
- Verbal fluency (word-finding)
Cognitive functions are typically affected differently from one patient to the next by factors such as the stage of the disease (with more impairment later in the disease), the number of lesion areas on the brain, and whether or not the MS is progressive.
But even if a patient is affected by MS cognitively, there are factors within your control. In general, the more fatigued you become, the greater the trickle-down effect on your mood, pain, thinking skills, and even safety. Everything from memory, word-finding and time-management to prioritizing time for loved ones, socializing and succeeding at work can suffer. We have seen patients who push themselves really hard to continue to keep life’s obligations going and as a result may function worse; living in a state of almost constant fatigue. When your mind and body is tired, your executive functioning suffers, resulting in greater impulsivity, less organization and planning. Fatigue can also make it difficult to be aware in the moment and apply medical recommendations to keep your health and safety first priority.