Primary progressive multiple sclerosis (PPMS) affects more than your mobility. You may also start experiencing problems with cognition. A 2012 study published in Cerebrum estimated that 65 percent of all MS patients have some form of cognitive impairment. This can manifest itself through:

  • thinking difficulties
  • trouble remembering things, especially from the past
  • difficulty learning new tasks
  • problems with multitasking
  • forgetting names
  • difficulty following directions

Since PPMS primarily affects the spine rather than the brain (as in other forms of MS), cognitive changes may come slowly. However, given that no medications have been approved to treat PPMS, lifestyle choices can make a significant impact on your overall condition. Learn some of the ways you can boost your cognition every day.

Regular exercise and cognitive function go hand in hand. The benefits of staying active can even carry over to cognition in PPMS. While you might not be able to comfortably do certain activities because of mobility concerns, some exercises can be modified to fit your needs. These include walking, swimming, yoga, and tai chi.

Aim for a few minutes at a time if you’re new to exercise. As you get stronger, you can go as long as 30 minutes before taking a rest. Talk to your doctor before trying out any new activity.

Sleep deprivation may heighten cognitive difficulties. With PPMS, sleep troubles are common because of nighttime discomfort. It’s important to get as much sleep as you can to improve your overall health, mood, and cognition.

Memory games can help improve both short-term and long-term memory skills that might be disrupted by PPMS. From internet games to smartphone apps, you’ll find a wide range of memory games to try.

Writing can also benefit your brain health. Even if you don’t consider yourself an avid writer, keeping a journal can aid your ability to find words and put sentences together. As an added bonus, you can go back and read old entries as a way of keeping your reading comprehension intact.

Aside from computer-based memory games and writing, you can also practice your cognitive skills through puzzles and problem-solving activities. Challenge yourself individually with a word game or math game, or find a new problem-solving app. You can also make this a family affair with a weekly game night.

Short-term memory issues can cause someone with PPMS to forget information, such as appointments, birthdays, and other commitments. Instead of beating yourself up over forgetting a date, consider using a personal organizer. Many phones are equipped with calendars and alarm clocks that you can set for a certain day or time as a helpful reminder. You can also go the traditional route with a paper calendar.

You may even consider making over your home office area with a new filing system. Create folders for bills, medical charts, records, and more. The more organized you are from the get-go, the easier it is to remember everyday items you need.

Reading can be a leisure activity, but it’s also a great activity for your brain. Whether you prefer paperback books, e-books, or magazines, there are multiple reading options that can offer cognitive challenges. You may even consider signing up for a book club — this has the added bonus of opportunities to socialize.

While MS medications typically aren’t prescribed for progressive forms of the disease, your doctor might prescribe others types of medications to manage some of your symptoms. However, some of these medications may be responsible for cognitive troubles — including meds you might be taking for other conditions not related to MS.

Talk to your doctor if you’re taking one or more of the following:

  • antidepressants
  • cholesterol-lowering drugs
  • muscle relaxers
  • seizure medications
  • steroids

Simply modifying the dose or changing medications (if you can) might improve your overall cognition with PPMS.

Counseling for PPMS is available on both an individual and group basis. Individual counseling often involves psychotherapy techniques that can help boost function and self-esteem. Group counseling has the added benefit of socializing — this alone can help keep your cognition going strong. Consider looking into an MS support group.

Testing for cognitive impairment may be difficult in PPMS. Your doctor will rely mostly on your symptoms as a reference. Neurological and memory testing may be helpful.

Your doctor might also administer a PASAT test. The premise of the test relies on basic number recall and elementary math problems. This takes a few minutes, but may be stressful for some.

In addition to these cognition-boosting activities, your doctor may also recommend a combination of occupational therapy and speech pathology.