Since the central nervous system (CNS) is the center of multiple sclerosis attack, it is inevitable that the patient’s cognitive ability is also affected; although, this aspect was not recognized in the past.  But recent surveys show that of those people suffering from multiple sclerosis, about 60 percent experiences mild cognitive problems; others may have mild to moderate temporary impairment, and the rest develop a more serious cognitive condition.

Specifically, cognitive abnormalities manifest in the patient’s inability to retain attention and concentration; impaired memory, especially of recent events; decreased speed on information processing; difficulty in abstract reasoning, problem-solving, and executive functions; impaired visual-spatial abilities, and; difficulty with verbal fluency, which makes it laborious for them to find the appropriate words to communicate. MS sufferers who used to have good memories may now have difficulties remembering appointments and other events.  Those who have relatively mild cognitive problems are conscious about their situation. But those who have severe cognitive condition or “cerebral MS”, usually lose their insight into the problem. They often encounter difficulties in planning and problem-solving that usually leave them inflexible to generate alternative solutions. But they are often unaware of this situation.  Because of this, those with cerebral MS may have a hard time comprehending the impact of their behavior on other people. Mood disorders are also a common occurrence among MS sufferers.

Since people with multiple sclerosis have different levels of cognitive changes, it is important to deal with them with love and patience.  Family, friends, and care providers have crucial roles in helping the MS sufferer minimize his cognitive problems. To better understand and adjust to these people, it is advisable to first identify and gauge their level of difficulties by testing. This is done by a speech pathologist or by a neuropsychologist.  In addition, there are certain techniques that can help alleviate their situation and manage their cognitive problems. Besides, cognitive problems due to multiple sclerosis do not worsen over time.

Make a list and calendar of appointments.  Since an MS sufferer has problems with his memory, it is very helpful to prepare lists of things to do, shopping, appointments, and other important events.

Memory notebook.  This is necessary in keeping track with daily events, reminders, and messages of family and friends. The MS sufferer may get a loose-leaf or an electronic personal organizer that he can carry wherever he may go.

Recorder.  A tape recorder can be of great help to remind the MS sufferer of his activities.

Simple directions.  It is also helpful to ask people to keep directions simple for easy memory retention.

Repeat information. Aside from asking for simple direction, it can also be helpful to repeat information given and write down important points during discussion.

Stay calm. In the event when memory fails, it is best to take a few minutes to calm down before proceeding with any activity or conversation.

Organize.  One of the best things to do is to avoid a cluttered environment.  It is very helpful to organize and arrange things to maintain a familiar setting.  For example, an MS sufferer, with the help of family or care provider, may set a particular place for storing frequently used things, like wrist watch, mobile phones, car keys, and other important items.  

Conducive setting. To help the MS sufferer concentrate and maintain focus, it is advisable to engage them in conversation in a quiet place to avoid environmental distractions.

Eye contact.  Remember to establish good eye contact during conversation.

More techniques can be learned as one goes along the journey with a multiple sclerosis patient having cognitive problems.

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