Thinking and memory problems

Cognitive dysfunction (otherwise known as brain fog) is a common yet invisible symptom of MS. It can be frustrating noticing changes to your memory and how you’re thinking – particularly as people around you may not notice.

MS is an autoimmune condition that attacks myelin – the protective layer around nerve cells in the central nervous system, including the brain, spinal cord and optic nerves. MS causes damage to these connective signals, making it harder for the brain to send messages to the rest of the body. This can cause symptoms like cognitive dysfunction.

Common thinking and memory problems could include difficulty with:

• a feeling of brain fog
• planning and problem-solving (executive functioning)
• concentration and attention
• memory, such as recent events, information or tasks
• remembering the right word to say (i.e., a word is on the tip of your tongue)
• processing information, such as instructions
• visual and spatial abilities (for example, judging speed, distance and objects around you).

For many people living with MS, cognitive change can be mild or fluctuate from day to day. There are also steps you can take to manage this symptom and improve your brain health.

Cognitive fog – however mild – may include difficulty thinking or concentrating, multi-tasking, forgetting words in the middle of conversations or starting a sentence and trailing off mid-way.

If you or someone close to you is experiencing brain fog, speak to your GP (general practitioner) as soon as possible. Whether you’ve been diagnosed with MS or not, they can help you find answers and make changes to potentially improve symptoms.

You can also call us on 1800 042 138 to speak to one of our friendly and understanding team members.

If you’re experiencing cognitive fog, there are many factors that can contribute to your symptoms. These can include:

• fatigue or poor sleep
• hormonal changes for women
• infections and other illnesses
• medications (a GP or MS nurse can advise you on your best course of action).

To manage cognitive fog, you can implement strategies to improve your thinking and memory. These could include:

• putting together a routine to plan and structure your day
• having a ‘memory centre’ at home – a pin board where you put the bills you need to pay and memos
• using a diary or your smartphone for memory prompts, reminders and planning
• prioritising one task at a time and removing distractions (e.g., background noise) when possible
• breaking down big tasks into smaller chunks and working on them over a few days
• avoiding doing things when you’re tired or anxious. This may worsen your ability to focus
• investigating other things that could be causing cognitive dysfunction.

If stress and anxiety are big triggers for your cognitive fog, you could also manage your symptoms with things like meditation, yoga, regular walks, breathing exercises and guided relaxation.

For more severe cognitive difficulty, you may be referred to a neuropsychologist, speech pathologist or occupational therapist, who can help you retrain your brain with clinical exercises.

This page has been reviewed and approved by Executive Manager Client Engagement and Wellbeing Jodi Haartsen. Jodi is a registered MS Nurse who has helped thousands of patients over her 20 years’ experience at Eastern Health MS service in Australia, in several roles including nurse educator, research nurse and nurse practitioner. Jodi is the 2022 winner of the global MS Brain Health Leader Award in the Independent Healthcare Professionals category.