Everyday Activities That Boost Cognitive Health for People with MS

By Erica Patino
Reviewed by Jeff Wilken, Ph.D.
December 08, 2023

If you’re like up to 65% of people living with multiple sclerosis (MS), you or your loved ones may have noticed changes in your cognition—which refers to your ability to think and includes memory, attention, reasoning, focus, and information processing speed.

Cognitive functions like these can be affected by brain changes related to multiple sclerosis itself. Some medications used to treat the symptoms of MS, such as steroids, muscle relaxants, and antidepressants, can also interfere with cognition, according to the Cleveland Clinic. And the emotional issues common in MS, such as depression, can also make it hard to concentrate, as can fatigue and a lack of quality sleep.

If you’re concerned about your cognition or aren’t feeling as sharp as you once did, there are everyday steps you can take to help boost your cognitive health. First, though, be sure to talk to your neurologist. “Sometimes, it is helpful to have a neuropsychological assessment done to determine exactly where the problems are. With that, people may benefit from cognitive rehabilitation therapy, both to work on the problems that were identified, as well as to come up with strategies to help compensate for those difficulties,” says Dana Cooper, M.D., a board-certified neurologist in Los Angeles.

How Can You Keep Your Mind Sharp?

Activities that are mentally stimulating may benefit cognitive health, according to the National Multiple Sclerosis Society. Beyond staying mentally engaged, experts say that the best thing people with MS can do for cognition is also what’s best for your body: Follow a healthy lifestyle.

Here are a few strategies that may offer a cognitive boost.

Keep Your Mind Engaged

Activities that stimulate your thinking, engage your imagination, and challenge your problem-solving skills may all be helpful. Try to take up activities that are good for your mind, including:

  • Reading
  • Journaling
  • Playing board games
  • Doing puzzles
  • Learning a new language
  • Learning to play an instrument

Staying socially active may help with this, as well. “For many of my patients, social isolation is their single biggest obstacle to enjoying life,” says Jonathan Howard, M.D., a board-certified neurologist and associate professor of neurology at NYU Grossman School of Medicine in New York City. Spending time with family and friends may be a big help, as can joining an MS support group, participating in a book club, or being active at your place of worship, for example.

Get Regular Physical Activity

While more research is needed, early evidence suggests that exercise may improve cognitive function in people with MS.

"Any movement is beneficial [to cognitive health]," says Howard. "While vigorous exercise might not be possible for all MS patients, almost everyone can do some form of exercise."

The NMSS recommends at least 150 minutes of physical activity per week for many people with MS, and they encourage making gradual progress toward this goal based on ability. If some exercise is difficult or painful for you, physical therapy and occupational therapy may help you identify exercise adaptations to suit your ability level.

“A lot of people also find that meditation and stretching can improve focus as well as physical symptoms,” Cooper adds.

It’s important to speak with your doctor before starting an exercise program. It should be appropriate not only for your MS, but also for any other health conditions you may have.

Eat a Healthy Diet

A nutritious diet means eating plenty of fresh fruits and vegetables and curbing your intake of junk food. “There is no reason to be afraid of pizza and ice cream now and then. Just don’t make them a daily part of your life,” says Howard. It’s also a good idea to either skip alcohol or drink only in moderation. That’s one drink or fewer per day for women; and, two drinks or fewer per day for men.

Avoid Smoking

In addition to being bad for your lungs and overall health, smoking is shown to directly impact MS disease activity, according to the Cleveland Clinic, and can worsen cognitive symptoms. Smoking cessation medications may help you kick the habit; talk to your doctor if you smoke and are ready to quit.

Get Enough Sleep

Pain, stiffness, and bladder issues can contribute to sleep problems in people with MS. "However, the biggest problem with sleep is that most people just don’t get enough," Howard says. And not getting enough sleep can increase fatigue and worsen cognitive symptoms.

Aim for eight hours of sleep a night; and, if you're still feeling tired, talk to your doctor. They may help you find strategies that can help you get more rest. And if lack of sleep isn’t the cause of your fatigue, they may help you find treatments that can help you gain more energy.

Can Medication Help?

There may be products that claim to help keep your memory sharp or boost brain health, but there’s little evidence to support most of them. “Unfortunately, there is no pill to improve cognition,” says Howard.

"Some people with MS report feeling better with stimulants such as Adderall [amphetamine and dextroamphetamine] or Ritalin [methylphenidate], but there is not much formal evidence to support their use in MS,” he notes. Talk to your doctor about whether medications like these may be helpful for your symptoms.

In general, a healthy lifestyle is a great tool for helping all symptoms of MS—including effects on cognition. Talk to your neurologist about whether these strategies could work for you, or if cognitive rehab may be a good option for your needs.

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