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Cognitive dysfunction is something that half of multiple sclerosis patients develop and, in some cases, it is the very first symptom of the disease.

People that suffer from multiple sclerosis are typically affected on a cognitive level. This means that some of the brain’s functions are altered, causing people to lose the ability to learn and focus, affecting their memory, their problem-solving capacity, their speech, and even how they perceive the environment.

Understanding cognitive dysfunction

Cognitive changes can happen at one or multiple levels. Some MS patients experience a mild form of cognitive dysfunction (CD), which means that only one or two areas are affected. Some of the functions affected are:

  • The ability to process information. People who have MS can’t fully benefit from their five senses, which affects the way in which they perceive the environment around them.
  • Capacity to focus. A person that doesn’t have MS can normally divide their attention, which translated into the ability of multitasking. When someone suffers from MS, they lose their ability to concentrate, and their attention span is significantly decreased.
  • Speech is another cognitive function that’s affected. Because MS attacks the brain, people have trouble in finding the right words.
  • Visual perception. When someone suffers from multiple sclerosis, they often have trouble perceiving the environment as it is, as this condition affects vision and all things that are related to visual perception.

CD is one of the reasons why people who suffer from MS have to quit working or studying, and it is typically one of the first symptoms of this condition. There are, of course, compensatory strategies that people who suffer from MS can turn to, to discover new tools and ways to keep on going despite this problem.

How to recognize cognitive dysfunction

Along with fatigue, CD is a symptom that can severely decrease the quality of life, which means that it’s important to recognize it as soon as possible and take necessary measure to diminish its impact. Cd is something that can affect a person’s relationships, their daily activities, plus their employment. In many cases, the people that notice the first signs of CD are not the patients, but rather close friends or family member. When a person starts experiencing the first CD symptoms, they will:

  • Experience having trouble speaking properly, remembering common words, or difficulty in expressing their ideas. Speech impairment become particularly noticeable when MS patients start having trouble in maintaining a regular conversation.
  • Have short-term memory loss episodes, where they fail to remember some of their routine activities (how to perform a certain task at work, forgetting to pick the kids up from school, etc.).
  • Have troubles is making rational decisions. People who suffer from MS will show poor judgment, making decisions they wouldn’t normally make, or doing things that don’t make sense for the others around them.

How to treat cognitive dysfunction

Cognitive rehabilitation is a process that involves recognizing the troubles an MS patient is facing and coming up with an individual restoration plan. This plan normally includes both restorative and compensatory tools and activities, to help the patient stay on track and aid them in living a life as normal as possible.

Some of the most common restorative activities include:

  • Memory and learning exercises. Because memory is part of a person’s cognitive functions, people who have CD will experience short-term memory loss, which affects their ability to learn.
  • Repetition. A person who suffers from MS is encouraged to constantly repeat the information they hear, helping them improve their attention span. Part of this repetition activity is practicing the bit of information regularly. The process is similar to that of studying for an exam, where the student is looking to improve their ability to store information.
  • Memory association exercises. One of the most common practices for MS patients is to help them remember new information by making associations. For instance, if an MS patient meets someone new and has trouble in remembering their names, they can associate the name with a place, another person, a color, a movie, or whatever helps them remember.

Compensatory activities are a set of exercises and tools that helps MS patients replace some of the cognitive functions they lose, like:

  • Activities that help people plan. Planning is one of the activities that’s normally affected by multiple sclerosis. When people lose the ability to plan and prioritize, a calendar might be a useful tool. Whether it’s a digital or printed calendar, this can help people keep track of each of their activities. Phone reminders are also a good tool that can let patients know about their upcoming activities.
  • Taking constant breaks. It’s normal for people who suffer from MS to feel fatigue because they lose their cognitive functions. It’s important to recognize that MS is a condition that implies taking constant breaks, to refresh and empty the mind.
  • Avoiding multitasking is very important, as it stresses out the brain, and causes a lot of frustration among MS patients. Part of the emotional changes of an MS patient is the anxiety caused by the idea of not being able to fulfill their tasks. Taking things one step at a time, and doing one thing at a time is very important.
  • Removing distraction can help MS patients focus better than they would in a loud or agitated environment. MS patients are very sensitive to visual and auditory distractions, which makes their ability to focus or memorize information a lot more difficult.


MS patients that have to deal with CD should know that there are appropriate management activities for this type of issue. It’s important to educate not just the patients, but also their family members and close friends. There are a series of interventions that can be followed in order to compensate for things like memory loss, concentration deficit, or the ability to plan and prioritize. While it’s true that CD affects day-to-day activities, there are measures that can make the situation better, like the ones listed above.

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