Doing everything we can to maintain cognitive reserve with MS
I recently learned about the concept at a CMSC annual meeting
Written by |
Contrary to popular belief, I did not attend this year’s Consortium of Multiple Sclerosis Centers (CMSC) annual meeting just for the buffets and to loot the vendors.
I was there mainly to represent the Paralyzed Veterans of America’s multiple sclerosis (MS) committee and raise awareness of its role in assisting veterans with MS. But I also helped deliver a presentation about patient input in their healthcare, and I attended other presentations, including one on the topic of cognitive reserve.
It had my complete attention because I had recently undergone a full cognitive examination to establish a baseline in case MS started affecting my cognition. Cognitive reserve posits that a person can have a reserve of mental skill and agility to compensate for cognitive decline, not unlike the way a physiologic reserve helps to compensate for lost physical ability.
Developing a reserve
The first MS symptoms I was aware of were physical. Right-sided foot drop was the most prominent, and when I ran out of energy to lift my foot, I began to compensate by swinging my leg to the side rather than straight ahead. As my physical disability progressed, so did the ways I compensated for it. I used therapy, exercise, medication, and eventually, assistive devices. Each has helped maintain a reserve, as has just being aware of my limitations and trying to abide by them.
Building a cognitive reserve works on the same idea. Right now, I seem to have cognitive difficulty only when my physical reserve has run out and I’m extra-fatigued. When brain fog makes me feel like I’m trying to think through Jell-O, I change my technique by taking extra time to think about and formulate responses. My life would probably be different if I’d done more of this all along, but this is merely my brain taking a slow, outwardly swinging step, instead of a straight-ahead one.
It turns out I’ve been doing things to aid my cognitive reserve all along, even before I knew what it was. Writing this column is a form of mental exercise for me, and I also challenge myself with learning a foreign language, or with word and logic puzzles. While I haven’t utilized formal cognitive therapy, I have experimented with compensatory medication, and I use virtual assistants, voice-to-text technology, and hearing aids to keep my cognitive reserve filled simply by decreasing the potential burdens to it.
I’ve noticed that as my physical ability and my ways of compensating decrease, the awareness of my cognitive abilities has increased. Even in moments of deep despair over not being able to walk or fully use my hands, I comfort myself with knowing that at least I still have my mind. The downside, of course, is that the fear of losing something increases as I run out of things to lose, which raises the question of what happens when I run out of reserve? I know what the answer is on the physical side because I’m living it. I hope the cognitive side is different.
I’m not going to end on that note. Now that I’m fully aware of cognitive reserve, I’m going to do everything I can to maintain it, including by exercising my mind to the best of my ability, being open to medical interventions, and using any assistive technology available.
I didn’t see, or refused to see, the physical disabilities I would experience with MS, and have always felt one step behind when it comes to compensating for them. I won’t make the same mistake with the cognitive ones.
Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.
Leave a comment
Fill in the required fields to post. Your email address will not be published.