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Cognitive problems or ‘cog fog’ is a common symptom of multiple sclerosis (MS), affecting around half of all people with the condition. Cognition refers to memory and thinking, and is used to describe forgetfulness, trouble concentrating, and confusion that can be experienced by people living with MS.

Despite being invisible, cog fog can have a huge impact on your daily life.

Changes in cognition are often subtle and the severity can vary day to day – which means that people living with MS sometimes won’t recognise cog fog as a symptom of their condition. It may, however, feel as though you are going through a grieving process when you realise that your mental capabilities are being affected, even when the changes are gradual.

If you notice any changes in your memory or thinking, report it to your healthcare team as soon as possible. They can help to identify the best management plan and tools for you.

For support in preparing for appointments with your healthcare team, visit Ready to Talk MS to make the most of your MS consultations here.

Cog fog can show itself in number of ways – below is a handful of examples:

Memory and recall

You may find that your memory isn’t as sharp as it once was. You struggle to recall whether you’ve put detergent in the washing machine or forget about plans you’ve made with family and friends. A great idea is to use your smartphone to record reminders or start noting down plans in your diary. Establishing a fixed routine could also help, as well as having a designated place to keep essentials, such as your glasses, keys, and wallet, to make them easier to find and to help you to feel organised.

Word finding

Are you struggling to pinpoint the word you want to say? Or feel like the word is ‘right on the tip of your tongue’ but you just can’t get it? This is something everyone – living with MS or not – can relate to. Describing the word may help – for instance, instead of saying ‘doctor’, you can say ‘the person who treats you when you’re sick’; instead of ‘slipper’, you can explain ‘shoes you wear in the house’ – ensuring that you keep talking, without letting cog fog get in the way.

Concentration and attention

Difficulty keeping up with conversations or feeling overwhelmed by information is another unpleasant characteristic of cog fog. You may find it harder to focus your attention, and easier to become distracted. Try reducing distractions when completing important tasks, for example, by asking people around to stop talking when you make calls. When possible, be sure to avoid complex tasks when you’re particularly stressed or tired.

Information processing

Cog fog can cause your thinking to become slower and processing information can take longer than expected. This may become especially clear when information is given to you quickly, or when you are provided with a large or complex set of instructions. Again, reducing distractions may help, as could dividing information into bite-size, manageable chunks.

Visuospatial abilities

You may find it a struggle to judge visual information, such as the accuracy of space, speed, and distance. This is the skill which is called into action when you are walking through a door or using a map. Today’s technology of sat-navs and smartphones with maps can be invaluable in helping people to help overcome this symptom – but don’t forget that it’s also a great idea to gain the support of family and friends, who may not realise this is a symptom of MS and will be more than happy to help guide you when possible.

Planning and problem solving

Making important decisions is a challenge for the best of us, but even more so when cog fog strikes. You may find it difficult to make your mind up about something or think about the long-term consequences of actions and behaviours, which then can make it difficult for you to plan your days and could result in confusion and worry. The people close to you may notice this cognitive change before you do. Talking through important decisions and getting additional perspectives from people you trust could help reduce this stress.

While cog fog may seem overwhelming and intimidating, there are many different forms of support available to help manage any changes you experience. The best course of action is to monitor your symptoms, and speak to your healthcare team as soon as you notice any changes.

UK | January 2022 | 157025