MS and Cognitive Impairment

Instructor: Danielle Haak

Danielle has a PhD in Natural Resource Sciences and a MSc in Biological Sciences

Multiple sclerosis is a condition affecting the brain and spinal cord, and patients experience a wide range of symptoms. In this lesson, we'll focus on cognitive changes that occur as a result of multiple sclerosis.

What Is Multiple Sclerosis?

Jeff was always a coordinated athlete, but when he was in college he suddenly began having problems maintaining his balance. He also experienced bouts of tingling and numbness in his arms and legs. Once Jeff realized these symptoms weren't going away on their own, he decided to see his doctor and underwent a series of tests. Ultimately Jeff was diagnosed with multiple sclerosis, a condition he had heard of but didn't know many details about.

Multiple sclerosis, or MS, is a medical condition that affects the brain and spinal cord. The body's immune system begins attacking itself, causing a range of symptoms that can gradually get worse over time. Specifically, the immune system attacks the protective covering on nerves (called myelin), altering the rate at which nerve signals are sent and affecting muscle activity. When myelin is damaged, it forms scar tissue called 'sclerosis', which is how the condition gets its name.

Like Jeff, most patients will be diagnosed during adulthood before the age of 40, and common symptoms include muscle weakness or numbness, decreased coordination, problems with vision and speech, and poor balance. These are the most common symptoms, but there are others that present as well, one of which can be cognitive impairment.

Multiple sclerosis has many different symptoms.
Multiple sclerosis symptoms

Cognitive Impairments

Though each case of multiple sclerosis varies in its symptoms and its impact on the patient's quality of life, we can take a broad look at different cognitive impairments someone with MS might experience. It's estimated that about half of people with MS will experience some type of cognitive impairment as a result of the disorder, though only 5-10% experience impairments severe enough to seriously affect daily life. In very rare cases, impairment may be severe enough to warrant continuous care in a long-term facility.

What do we mean by cognition? That's a good question. Cognition is a term used to describe mental processes like thinking, understanding, learning, and remembering. Each of these processes can become impaired (or weakened) based on how MS affects the body, which is where the term cognitive impairment comes from.

Specifically, short-term memory, attention, concentration, processing information, planning, prioritizing, spatial awareness, and word selection are functions that often become disrupted (usually decreased) due to MS. Functions like long-term memory, general intellect level, conversation, and reading comprehension are less likely to be affected by MS and usually stay intact, even as the condition progresses.

Most cognitive changes take place long after a person is initially diagnosed rather than early on, and it's not common for one person to experience all of the conditions listed above. Additionally, once changes to cognition begin, they typically progress slowly; however, they are extremely unlikely to be reversed. In other words, most cognitive changes that occur are permanent. Now that Jeff's case has been diagnosed, he and his doctor can watch for early signs of cognitive impairment.

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