What are the effects of MS on cognitive function?

Cognitive function is our ability to think, process information, make decisions, concentrate, and remember facts. Good cognitive function is essential for everyday activities at home or at work.

About 50% of people with multiple sclerosis (MS) have some changes in cognitive function due to the medical condition. The severity of the changes and the affected areas of the brain vary between people. The changes may start slowly and may first be noticed by friends and family as changes in personal habits or behaviour.

It is not unusual for some areas of the brain to be severely affected while other areas are normal. About 5% to 10% of people with MS will have changes severe enough to affect their ability to function. Although changes in cognitive function usually occur in people who have had MS for a long time, they may also be seen earlier in the course of the condition. The severity of the changes may vary within the same person over time, and it is not related to the severity of physical symptoms caused by MS.

Memory is the part of cognitive function that is most often affected. Other areas of the brain that are affected include those responsible for the speed of information processing, the ability to plan and prioritize, visual perception, problem solving and decision-making, concentration, and the ability to find words. Multitasking (shifting back and forth between different tasks) and dividing attention between different tasks may also become more difficult.

These cognitive function changes affect many people with MS and can have an effect on their lives at home and at work.

If you are concerned about the risk of physical disability and cognitive impairment, talk to your doctor. You can work together to find ways to live with MS.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Cognitive-Function

Why can MS cause changes in cognitive function?

The main reason why MS causes cognitive function changes is its direct effect on the brain. MS damages nerve cells and myelin (the protective layer surrounding your nerves) in the brain. This affects brain functions, including cognitive function. Because the exact pattern of damage due to MS is different for every person, the changes in cognitive function also vary between people.

MS also has an indirect effect on cognitive function. The disease causes fatigue, stress, and depression. All of these things, especially fatigue, can have negative effects on cognitive function. This indirect effect can cause cognitive function changes on its own or make existing changes more difficult to cope with.

If you are concerned about the risk of physical disability and cognitive impairment, talk to your doctor. You can work together to find ways to live with MS.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Cognitive-Function

How can cognitive function changes be treated?

The first step in treating cognitive function changes is to consult a doctor. The doctor will refer the person to a trained health care professional who will evaluate all areas of cognitive function using a group of tests. Once they find out which areas have been affected and how severe the changes are, treatment and coping strategies can be recommended. The doctor and other health professionals will also try to ensure that cognitive function changes are not due to other potential causes such as aging, other medical conditions, or medications.

Treatment varies according to which areas of cognitive function are affected and the severity of the changes. If the problem is mild, strategies such as using lists, electronic reminders, sticky notes, day planners, and alarms can help. For more severe problems, professional assistance or care may be needed, especially if the person is no longer able to function on their own.

A technique called cognitive rehabilitation uses special exercises to train people to improve their cognitive function and compensatory techniques to help compensate for the function that has already been lost. Studies of rehabilitation have shown mixed results. Compensatory techniques seem to have the best results. Support from family, friends, and work colleagues can also help the person cope with cognitive function changes. Other health professionals such as speech language pathologists and occupational therapists can play a role in supporting people with cognitive function changes.

Medications may also be helpful. A number of options are being studied. Clinical studies have shown promising results for one type of interferon beta-1a, which is used to treat other MS symptoms, and for donepezil, which is used to treat Alzheimer's disease. Since some disease-modifying medications have been shown to reduce relapse rate and slow the progression of disability, it is possible that they may also be helpful for cognitive changes caused by MS. Talk to your health care professional and ask whether your MS medication can also help with cognitive function changes.

If you are concerned about the risk of physical disability and cognitive impairment, talk to your doctor. You can work together to find ways to live with MS.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Cognitive-Function

How could cognitive function changes affect me in the workplace?

Cognitive changes, such as memory lapses, concentration problems, difficulty making decisions, and slower information processing, can make it more difficult to do your job. Cognitive changes and fatigue are the two main reasons why people with MS leave their jobs.

The impact of cognitive changes in the workplace depends on the nature and severity of the changes. If you think you may have cognitive changes, see your doctor. Your doctor can identify what the specific cognitive problems are so that you and your health care team can come up with a management plan.

Often, compensatory techniques such as organizers, day planners, alarms, and reminder notes are enough to let you continue your usual activities. In other cases, it may be necessary to ask your employer for specific workplace accommodations.

Workplace accommodations are reasonable changes made by an employer to an employee's working environment and responsibilities that make it easier for the employee to continue work in the face of illness or disability. An employer must provide these accommodations as long as they do not cause "undue hardship" (measured by financial cost and health and safety issues) to the employer, or interfere with a "bona fide occupational requirement" (a practice or rule that is justified because it is based on skills or abilities that are required for the job).

Accommodations that may be helpful for cognitive changes include the following techniques:

  • reducing noise and distractions by moving to a private office
  • using room dividers or noise-cancelling headphones
  • organization aids such as day planners and PDAs (personal digital assistants)
  • providing written instructions
  • allowing regular rest breaks
  • offering flexible work hours or providing more structure
  • decreasing job stress

Asking for workplace accommodations means letting your employer know that you have MS. It is up to you to decide whether or not to do this, and if so, when to do it. You have no legal obligation to tell your employer you have MS unless you need workplace accommodations or time off because of the medical condition. Before disclosing your condition to your employer, get professional advice, ask for moral support from friends and family, and familiarize yourself with the rules and regulations affecting you, including your health coverage.

If you do decide to disclose your condition, plan what you will say and how you will say it. When you speak with your employer, describe specifically how MS is affecting your ability to do your job (the Multiple Sclerosis Society of Canada offers a booklet for employers entitled "MS in the Workplace: An employer's guide"), explain that symptoms may fluctuate over time, and offer suggestions of workplace accommodations that will help you continue to perform your job (you can consult an occupational therapist or the MS Society for suggestions).

Your employer cannot fire you simply for having MS. Firing can only be justified if you are unable to perform your job even with accommodations. Even in this case, your employer must put the specific problems in writing and discuss them with you first. You have the right to respond in writing to these concerns, stating whether you agree or disagree, and to challenge the firing as a wrongful dismissal. If you want to challenge the firing, seek legal advice. The same holds true if you are thinking of leaving your job because you were refused workplace accommodations.

If you have decided to leave the workforce completely, there are a number of financial support options open to you. Your employer may provide some health coverage and disability benefits. If you subscribe to a private health and disability coverage plan, this can also help. If neither of these situations apply, some assistance may also be available through the Canada Pension Plan, the provincial government, and Employment Insurance (EI). These plans may require proof that your illness is preventing you from doing any job, and may also require that you have worked or contributed to the plans for a specified period of time. Your doctor, local MS society, or service clubs may be able to assist you in finding sources of financial support in your area.

If you are concerned about the risk of physical or cognitive disability and how they can affect your job, talk to your doctor. You can work together to find ways to live with MS.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Cognitive-Function