- Estimates of prevalence of cognitive dysfunction in MS
range from 40-70%. No correlation exists with the degree of physical
disability, and cognitive dysfunction may occur early in the course of
disease. This complication of MS can be a significant problem affecting
family and social relationships, as well as employment. Areas of cognition
affected include comprehension and use of speech, attention, memory, visual
perception, planning, problem-solving, and abstract reasoning.
- Treatment approaches for cognitive dysfunction include
cognitive retraining and use of compensatory strategies. Cognitive
retraining involves use of repetitive drills and mentally stimulating
exercises designed to strengthen those areas of cognition that are weak.
Compensatory strategies emphasize coping methods or organizational skills to
help the individual use his strengths to compensate for areas of relative
weakness, including such strategies as maintaining a consistent routine,
making lists, keeping a daily planner, and organizing the home or work
- In providing education on MS management to patients with
cognitive impairment, it is important to involve family or caregivers in
training, provide step-by-step instructions, and present information in both
a visual and verbal format. New topics should be presented at times when
fatigue is less likely to be an issue.