Prof Dawn Langdon shares some advice on invisible symptoms on World MS Day 2019

Difficulties with memory and concentration, known as “cognition”, are part of many people’s experience of MS. Sometimes this is called “cog fog”. The part of thinking that is most often, and most severely, affected is information processing speed. This is a bit like band width in a computer. When information processing speed is reduced, it can make it harder to take in information that is spoken and particularly when a person is speaking quickly. It can also be harder to manage multiple channels of information arriving at the same time. This is why having a sat nav speaking to you whilst you are driving might not be a good idea. Some quite simple solutions to this can often work quite well. For example, if you work in an open plan office, moving your desk to a quieter corner with less interruptions and distractions can be helpful. Asking friends and work mates to remember to speak slowly (not ridiculously so, just not very quickly), can also be a good move.

Another aspect of thinking that MS can impact is memory. Although information that has been stored long term is likely to be OK, remembering to do things can be harder. This can be upsetting for you and for friends, family and work mates. You may feel that you have let them down. They may wonder about your commitment. Again, fairly simple things can help. Diaries, schedule and reminders can help keep you on track. When you have a lot to do, you can plan your activities at the start of the day, perhaps scheduling times to rest, catch up or check your task list.

There are some background things that you might want to think about. You probably know that people with MS can experience increased levels of anxiety, depression and fatigue. Although these don’t have a big effect on your absolute level of mental performance, they make a big difference to how you feel and how effortful mental activity feels. It is worth getting these things checked out by your health care team and if necessary, putting management plans in place. Also, some medications given for MS symptoms can affect cognition, for example the anticholinergics given for continence issues, so it might be worth chatting to your doctor about your prescription profile.