Cognitive Changes with Secondary Progressive MS
This progressive form of multiple sclerosis (MS) can cause changes in memory and other cognitive abilities, ranging from mild to severe. Knowing what to look for and how to manage the changes can make a difference.
Secondary progressive MS (SPMS) can affect both physical health and cognitive abilities.
Results from a small 2025 study found that just over 55% of people with SPMS experience some form of cognitive impairment.
The condition may affect memory and slow down the speed at which the brain processes information. It may also reduce communication abilities, reasoning faculties, or attention span. These cognitive effects are often mild and manageable, but they can vary in severity from person to person.
You can take steps to help maintain your cognitive health if you live SPMS. To manage the cognitive effects of SPMS, it's important to be proactive. Here are some strategies you can use to identify and manage cognitive changes.
Watch out for signs of cognitive changes
SPMS is a progressive condition. Over time, it can cause new cognitive symptoms to develop and also cause existing symptoms to get worse.
To identify cognitive changes, go for regular screenings. Guidelines from 2018 recommend that people with MS be screened for cognitive changes every year.
It's also important to let your doctor know if you notice changes in your cognitive abilities. For example, you might be experiencing cognitive changes if you're:
forgetting things more than you used to
having difficulty finding the right words to express yourself
finding it more challenging to keep up with conversations or familiar activities
showing signs of impaired judgment or decision making skills
finding it harder to navigate social relationships
receiving less positive evaluations at school or work
If you notice changes in your memory, concentration, or other cognitive abilities, let your doctor know. They may use one or more tests to check for cognitive decline.
Identify the cause of changes
If you experience cognitive decline, your doctor may use one or more tests to identify the cause of those changes.
SPMS is one of many things that can affect your cognition. Other medical conditions, certain medications, or lifestyle factors may also impair your cognitive abilities.
Your doctor's recommended treatment plan will depend on the cause of the cognitive changes. Your doctor may also refer you to a psychologist or other specialist for testing and treatment.
Try cognition exercises and activities
To manage cognitive symptoms of SPMS, a healthcare professional may advise cognitive rehabilitation exercises. Some 2020 research has found that implementing certain at-home, computer-based learning and memory techniques may help improve cognitive function in people with SPMS.
Your doctor or specialist may also encourage you to participate in mentally stimulating activities. This may help build your cognitive reserves. For example, you might find it helpful to complete crossword puzzles, play card games, write poetry, or learn to play a musical instrument.
If your doctor or specialist believes the cognitive changes are due to another medical condition, they may recommend other treatments to manage it.
If they think the cognitive changes are a side effect of medication that you're taking, they may advise changes to your treatment plan.
They may also advise you to make changes to your diet, exercise routine, or sleep habits. An overall healthy lifestyle is important for supporting your physical and mental health.
Make small changes to your daily habits
Tweaking your daily habits may help you manage changes to your cognitive abilities.
For example, it might help to:
Make more time for rest and take breaks when you feel fatigued or distracted.
Focus on one thing at a time and limit the amount of multitasking that you do.
Reduce background noise and other distractions when you're trying to concentrate.
Use an agenda, journal, or note-taking app to keep track of upcoming appointments, to-do lists, important ideas, and other information.
Set alerts on your smartphone to remind yourself about important dates, deadlines, or daily tasks.
If you're finding it difficult to manage your responsibilities, you may need to scale back on commitments at work, school, or in your personal life.
If you can no longer work due to the cognitive effects of SPMS, let your doctor know. They may refer you to a social worker or other professional who can help you learn if you're eligible for government-sponsored disability benefits.
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