03 Cognitive Wellness

Forgetfulness happens to all of us. Sometimes we forget names or appointments, struggle with finding the right word, or feel overwhelmed and disorganized. But what happens when you notice it occurring more frequently than it used to? When you have MS, you may find that you’re having more trouble with thinking and remembering. Many people with MS have changes in cognition. Cognition encompasses all the skills that allow us to pay attention, understand/use language, learn and remember new information, plan, organize and make sense of our world. If you’re experiencing such changes, you’re not alone. In fact, 65% of people with MS will struggle with cognition at some point. Along with fatigue, it is the leading reason for leaving the workforce on disability.

It’s frightening to feel like you’re not thinking as clearly or as quickly as you used to. It’s normal to worry about where it might lead. Many symptoms are mild, but even mild changes can have a big impact on daily life. Fortunately, there are strategies to enhance cognitive health and tackle cognitive challenges. Even small changes can make a big difference. Here are a few strategies to keep in mind when striving for cognitive wellness:

  • Pay attention to your mood. Emotional symptoms such as depression, anxiety, and stress, can make cognition worse. The opposite is also true, changes in cognition can increase worry, may cause some to feel hopeless, and have anxiety especially in social situations. However, it is important to know that emotional symptoms are some of most treatable symptoms of MS. Talk with your doctor about screening and treatment for depression, anxiety, and emotional symptoms.
  • Manage energy and fatigue. Physical and cognitive fatigue are real, so don’t try to push through them. Take breaks when needed and do more challenging tasks during energy peaks.
  • Exercise! Modify to account for physical limitations, of course. Exercise is neuroprotective and has proven to benefit cognition throughout the lifespan.
  • Make time for family and friends. Social interaction is associated with better mood and cognition.
  • Do something new and novel. Learn a new language, take a class, join a book club, learn an instrument or how to sing or paint. Engage in crafts and hobbies, if they are not too isolating
  • Let go of the “but I always did it this way” mentality, especially if those methods are no longer effective. Allow yourself to do things differently than in the past.


While keeping your mind engaged and active can support cognitive health, you may need tools for those times when you’re struggling with more specific issues, such as word retrieval or memory. Think in terms of function. Are you forgetting conversations? Appointments? Words? Here are a few tips to help you avoid hose frustrating moments:

  • Many memory problems can be improved with better organization.
    • Use tools such as calendars and reminders. Smartphones and computers make it easier than ever to sync devices to each other so that you can always have those schedules and reminders close at hand, and sometimes on your wrist!
    • A place for everything and everything in its place. Designate a single spot in the home to keep keys, mail, wallet so you always know where to look. Keep your system simple and consolidated.
    • Avoid using Post-its everywhere!
  • Attend to your attention. You can’t remember what you couldn’t process in the first place.
    • Limit multitasking! It’s overrated. Instead, make simultaneous tasks one thing at a time. Finish one thing before going to another.
    • Take in important information in a quiet place. Ask for repetition of information or for speaker to slow down to ensure you get it. Repeat it back to ensure you understood correctly.
    • Be aware of and minimize distractions. There’s a reason we turn down the car radio when we’re lost!
    • Know when you’re overloaded and take a break.
  • If struggling to find a word, keep the conversation going.
    • Talk around a word by describing its attributes or associations (eg “it’s red and goes on hamburgers”)
    • Use gestures
    • Name the category the word belongs to
    • Enlist the listener’s help. Whatever completes the communication loop counts as success.