Medical Science has been aware of the cognitive effects of Multiple Sclerosis for over 160 years. But, like with so many other MS symptoms, is no nearer finding a solution. I decided to write this post as I have been becoming more and more aware of my own cognitive impairment in terms of deteriorating mental abilities; poorer memory, slower thought processes and lack of drive or incentive.

Dementia is a very sensitive area of discussion. Perhaps, because it is an area of mental health that is so little understood by the general public. And, to some extent, by the medical professionals.

Multiple Sclerosis is also a complicated disorder, it becomes very difficult to compartmentalise individual symptoms as most are inter-connected in one way or another.

This is further complicated when you discover that not every symptom is due to the Multiple Sclerosis. But, may have a very real, rational alternative explanation.

Brain Fog is clouding your Perception

How to Improve cognitive impairment in MS

Having just returned from a two-week holiday in Mallorca, I had been full of ideas to turn this health Blog into the most amazing travel Blog which would fund my future travels and aspirations for retiring to Spain or France. A Pipe Dream! The trip to Mallorca confirmed that no matter how good a day my MS was allowing me to have, the Uhthoff’s effect compounding my all-too-frequent brain fog would prevent me from attaining this objective.

In many ways, the holiday had lived up to expectations. The travel, with disabled assistance, by Jet2 was excellent. The apartment was reasonably accessible for my wheelchair, which was a real boon for exploring the Santa Ponsa area. BUT, we had travelled in June, which was just too hot for my MS to cope with.

I have had MS for over 20 years and it is a condition that is gradually worsening. That does NOT mean that I can do nothing about it.

Is dementia and the associated cognitive impairment an inevitable complication of MS?

No, I don’t believe it is. Not everyone with Multiple Sclerosis will experience the same difficulties that I do. I have a friend diagnosed with PPMS (Primary Progressive Multiple Sclerosis) and he is badly affected physically; wheelchair bound with a severe speech impediment. Yet he claims to have no cognitive impairment at all.
Overt dementia in MS is rare. Most cases of cognitive impairment in MS are relatively less severe than those observed in classically dementing neurological disorders, such as Alzheimer’s disease, in which the patient loses memory of previous experiences and is unable to respond properly to environmental stimuli. However, cognitive impairment in MS can be extremely debilitating, with substantial negative impacts on daily living. Cerebrum Article

There are four subtypes of MS, defined by disease progression:

  • RRMS (Relapse-remitting MS)
  • SPMS (Secondary-progressive MS) The majority of patients diagnosed with RRMS will develop this within 10 or 20 years
  • PPMS (Primary-progressive MS) a steady , and often rapid, in symptom severity.
  • PRMS (Progressive-relapsing MS) the rarest subtype.

Those people who have RRMS are the least likely to experience cognitive impairment, but further studies are required.

Preventing or Delaying the Decline

I recently watched a fascinating BBC documentary about the wonders of the human brain. In which it demonstrated, for me. Both the amazing properties of the brain AND the fragility of this hugely important organ.

The brain is constantly developing, constantly learning and constantly renewing itself. When disease interrupts this process, cognitive impairment is inevitable.
Cognitive rehabilitation therapy is a nonpharmacological method of improving a specific cognitive skill through practice and training. Cerebrum Article

Learning a new skill will cause the brain to develop new areas, or connections, to cope with the demands of this new skill.

This new skill could be anything that you have not done, or tried, before. Anything that will tax your mind in one form or another.

It may be learning a new language, writing a book or taking up table-tennis. New physical skills require the new mental faculties to coordinate them. Learning a new language places demands on many areas of the brain, particularly memory.

The Power of Learning to expand the Mind and the Possibilities

If we understand that the brain is constantly developing and making new connections. It is finding new routes to accomplish new tasks. Then, it should be obvious that learning any new skill, mental or physical, will enhance the functioning of the mind.

I decided that I really needed to do something. My brain fog, my lack of cognitive ability, was getting so bad that I was becoming the proverbial vegetable.

I have long tinkered with the idea of learning to speak Spanish, Speaking fluently requires more than “Holá” or “Una cerveza grande, por favor”. Speak enough as hold a conversation. I have a number of Spanish language CDs but they were not working. Retaining the knowledge was the problem. I could not find the incentive to work.

Then, my father suggested duolingo, an online language learning service that was FREE. He already speaks reasonable Spanish, French and German. But, was planning to travel to Portugal so he wanted to add Portuguese to his resume.

At this point my father is in his early 80s and I thought “If he can do it, I have no excuse, MS or not”. So I duly installed duolingo on to my ‘phone and tablet and set about doing the Spanish course.

The Moment of Realisation

EUREKA! It was as if someone had switched the light on. Within a couple of weeks, my brain came back online and I could think clearly again. It was not instantaneous. It was not easy. But, the duolingo format for learning clearly gelled for me and I just wanted to do more and more.

One month later, and a fortnight in Mallorca, I am still not fluent in Spanish BUT my brain fog is still receding and I am still mentally active and alert. A success? Overwhelmingly YES. No my Spanish is not fluent, but it will be. I will continue to learn and improve, because I now have enthusiasm.

The Learning Process is just as Important as the new Knowledge

Will this work for you? Yes. It may be that learning to speak Spanish is not for you, but learning something else may be. Learning to play a musical instrument will involve previously unused parts of your brain. It is the learning process that is important not actually what you learn.

My improved mental clarity has been astounding.. Exercising my mind has lifted the brain fog and reduced the cognitive impairment. Learning to speak Spanish should have the dual benefit of lowering brain fog and communicating whilst on holiday.

I also firmly believe that changing my diet has had a profound effect on my well-being. Probably, to the point that has allowed me to begin this exciting new learning journey.

For those of you who follow my blog, you will be aware that I have been following the Wahls Protocol, not as stringently as I should but, enough as make a significant difference.

Using this newly discovered mental power

My inability to think clearly and my appalling memory recall has been a frustration. I have long considered myself an intelligent, well-educated man. But, the past few years of this MS brain fog has left me feeling more like the village idiot.

I am now more optimistic, and keen to try and get my life back on track. My Blogging for many years has had little direction or sense of purpose about it. I intend to remedy that and I have just signed up for an online training course to do just that.

Learning can be addictive and I hope that this is one addiction that I can put to some positive use.

How to handle MS “Brain Fog”

An article in WebMD entitled “Clearing away MS Brain Fog” discusses ways to manage this cognitive impairment:

The problem, Rypma says, is that communication breaks down between your brain cells and the blood vessels that provide the nutrients that help them work. That makes it harder for your brain to do its job. WebMD

I don’t, especially, like this explanation as they discuss ways to cope with the brain fog. Rather than ways to correct it, or at least minimise it.

Do you have any thoughts on this matter?

If I have made mistakes in this post. If you think I am incorrect about anything that I have said. Or, if you have anything to add. Or to ask then please leave a comment in the comment section below.

With my revitalised mental acuity I should be able to respond to any new challenge.

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This is clearly a comment from a non-native English speaker which is no reason to exclude it. The comment maker links to a web post on brain health that makes very valid points.

I love this comment because it made me use my brain to translate the intended meaning and encouraged my engagement with a new friend. Thank you so much for this thought-provoking comment.


I’ve been tinkering with the idea of learning chess for a few weeks, RRMS for the last 3 years, and you just inspired me to just go for it. The idea that challenging my mind will keep it spry (spyer?) is really empowering. For a disease that robs you of nearly all of your agency, that is crucial.


I think chess would be a wonderful stimulant for your brain. The sooner the better and take it seriously. The more you challenge the thinking process, the more the brain will grow to find new connections in the neural paths.
Please keep me informed of your progress. I will be rooting for you!

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