Cognitive Changes
Cognitive changes are common in people with multiple sclerosis (MS), affecting around half of those diagnosed and impacting daily activities such as memory, attention, and problem-solving. These difficulties can be subtle at first but may become more pronounced over time, reducing independence and quality of life.
What Are Cognitive Changes?
Cognitive changes refer to difficulties with mental processes including memory, information processing speed, attention, executive function, visual–spatial skills, and word-finding. People may notice slower thinking, trouble recalling recent conversations, difficulty planning tasks, or finding the right words in conversation.
What Causes Cognitive Changes?
Demyelination and neurodegeneration in the brain interrupt communication between nerve cells, leading to slowed information processing and memory deficits. Lesions in the frontal lobes and widespread white and grey matter changes particularly affect executive function, decision-making, and complex problem-solving.
Other factors, such as medication side effects, lack of sleep, depression, anxiety, stress, and fatigue, can also influence cognitive function but are not always directly caused by MS itself. For most people, cognitive symptoms are relatively mild and can fluctuate from day to day.
What Should I Do If I Experience Cognitive Changes?
If you notice difficulties with memory, planning, or concentration, discuss these symptoms with your neurologist, MS nurse, or GP promptly to rule out other causes and plan assessment. Routine cognitive screening using validated tools can detect early impairment and guide referral to neuropsychologists or cognitive rehabilitation services.
Self-Management Strategies
- Use memory aids: Diaries, calendars, and smartphone apps can help track appointments and tasks.
- Implement structured routines: Clear task lists and consistent daily schedules simplify day-to-day activities.
- Practice cognitive exercises: Computer-based training programmes or mental exercises can strengthen attention and processing speed.
- Engage in regular physical activity: Aerobic exercise has been shown to support cognitive function in MS.
- Prioritise good sleep hygiene: Regular sleep patterns and a restful environment improve mental clarity.
- Manage stress: Mindfulness, meditation, or relaxation techniques can help reduce stress-related cognitive difficulties.
How is it treated?
Cognitive rehabilitation led by occupational therapists, neuropsychologists, or speech therapists can use restorative and compensatory strategies to improve function and adapt routines. Restorative approaches focus on exercises to enhance memory, attention, and executive skills, while compensatory strategies teach the use of external aids and environmental modifications.
Pharmacological options for cognitive symptoms are limited, although some clinicians may trial medications such as memantine or stimulants on a case-by-case basis under specialist supervision.
General Information
Living with cognitive changes can be challenging, but support is available:
- Healthline – 0800 611 116 – Free health advice from trained registered nurses, available 24/7.
- Disability Connect – 09 636 0351 – Information, advice, and support for families of people with disabilities.
- Work and Income New Zealand – 0800 559 009 – Information about financial assistance that may be available to you.
Continuous monitoring and timely interventions by your healthcare team can help maintain cognitive function and improve quality of life.