Estimated prevalence in Western hemisphere is 50 per 100,000. More frequent in cold and temperate climates than in trpoics/subtropics.
MS Cognitive issues Justin C. Koenitzer, Psy.d.
Psychological Aspects of MS:Cognitive & Emotional ChallengesJustin C. Koenitzer, Psy.D.Clinical PsychologistOrlando Department of Veterans AffairsPrimary Care Mental Health Integration
General Overview of Multiple SclerosisImmune-related Disorder of the central nervous systemWhite matter plaques: inflammation and demyelinationPlaques become “active” and cause “flare ups”; chronicplaques can produce chronic symptoms50 per 100,000 people are have MSMore common in women than in menSymptom onset between ages 20-40
Cognitive Symptoms vary among and within people30-50% will develop mild cognitive impairments20-30% will develop more significant cognitiveimpairmentsMemory is most common cognitive complaint; severityof memory impairment does not correlate with severityof neurological symptoms or duration of illnessCognitive ImpactsFatigue is also a very common symptom20-50% will not develop cognitive impairments
Cognitive Impacts• Spastic muscle weakness• Numbness• Paresis• Trouble with walking• Dysarthria (slurred speech)• Diplopia (double vision) or other vision symptoms• Facial pain• Incontinence• Less common: seizures, vertigo, languageproblems,
Emotional Impacts1.) Depression –in approximate 25% of individuals with MSTwo Types: Reactive and or direct consequence of plaques2.) Euphoria –in approximate 25%+ of individuals with MSOne patient bedridden and unable to stand remarked: “youwill not believe me when I say I feel thundering well”3.) Anxiety—there can be so much UNCERTAINTY with MSOther major emotional impacts include emotionstypical of grief: denial, anger, loss , fear
Impacts on the Family• Pre-existing underlying difficulties can beexacerbated by MS• Role shifts within the family• Sense of burden—caregivers, children• Children of individual with MS may havefears/embarrassmentChronic Illnesses are not diseases of theindividual but rather diseases within a family
What can be done?Individuals with MS and their families should be open abouttheir thoughts and FeelingsFocus on what you CAN do as opposed to what you CAN’TEngage in Healthy Lifestyle Behaviors to combatcognitive/emotional impacts:• Exercise• Social connectedness• Cognitive exercise—reading, writing, games,• Coping Skills—avoid catastrophizing; stay realistic and positiveTake care of caregivers to avoid burnout—seek professionalhelp when needed