Is there anything people with MS can do to reduce dementia risk?

With more research highlighting that people with MS face a higher risk of dementia, it is natural to feel concern about how you might be affected. Here, the MS-UK Helpline team investigate and share what you can do to reduce that risk.

Cognitive symptoms are quite common in people living with multiple sclerosis (MS) and can have a very real impact on quality of life. Cognitive issues are caused by lesions within the brain or brain atrophy/shrinkage because of MS disease activity.

Although there may be some similarities, cognitive symptoms in MS are not the same as those someone with Alzheimer’s disease will face. It is important to remember that dementia is not a singular condition, but an umbrella term used to cover a range of disease conditions (Alzheimer’s disease, vascular dementia etc).

Dementia mainly affects older people, and the NHS says that after the age of 65, the likelihood of developing dementia ‘roughly doubles’ every five years. The NHS estimates that there are 850,000 people living with dementia in the UK.

The advice to the public from the NHS in terms of reducing the risk of dementia is to focus on maintaining a healthy lifestyle.

The NHS hosts and shares information about ‘can dementia be prevented?’, which says that you can help reduce the risk of dementia by:

• Eating a balanced diet
• Maintaining a healthy weight
• Exercising regularly
• Keeping alcohol within recommended limits
• Stopping smoking
• Keeping your blood pressure at a healthy level

MS Brain Health

Whilst it is important to keep your brain healthy to reduce the risk of dementia, it is also important to talk about ‘MS BrainHealth’. The discussions and thinking around maximising Brain Health were born from an international ‘consensus’ report first published back in 2015. There is evidence, described by researchers and clinicians as ‘overwhelming’, that says that early effective treatment can prevent irreversible damage from building up. The report made policy recommendations for neurological clinical practice based on the principle that ‘time matters’ when it comes to treating MS.

The MS Brain Health report has a six-point Brain Health guide for people directly affected by MS. These six evidence-based outcomes and recommendations for a brain-healthy lifestyle are targets that most people with MS can aim to follow or work towards.

1. Keep as active as you can – being active can help to preserve brain health in people with MS
2. Keep weight under control – obesity is associated with higher numbers of MS lesions
3. Keep the mind active – protect against cognitive problems with reading, education, hobbies, artistic or creative pastimes
4. Avoid smoking – cigarette smoking can decrease brain volume in people with MS, increase relapse rates, disability progression and increase cognitive problems
5. Be aware of excessive alcohol consumption – unsafe levels of alcohol are associated with reduced survival in people with MS
6. Continue taking medicines that are prescribed – other conditions such as high blood pressure, high cholesterol, heart disease and diabetes can negatively impact the MS disease course. It is important to be responsible for managing and monitoring any other health conditions that you may develop

Did you notice that the two sets of recommendations for brain health in MS and reducing the risk of dementia are almost identical?

There’s a huge amount of crossover.

Working towards a positive impact on MS

Professor Gavin Giovannoni said in a recent post on his Substack newsletter about MS and dementia that he now refers to MS as ‘a preventable cause of dementia’. He feels strongly that modern and highly efficacious Disease Modifying Therapies slow the loss of brain volume and vastly reduce the risk of long-term cognitive impairments due to MS.

A healthy brain that functions well is very important for people with MS. A healthy brain may help to reduce symptoms, reduce the likelihood of new ones developing and have a positive impact on the progression of a person’s MS. It is felt that without treating MS as early as possible, MS can ‘smoulder’ in the background and lead to worse outcomes for the individual over time.

Leading a brain-healthy lifestyle is very important for both living well with your MS but also you can feel confident that you are doing all you can to preserve brain volume, and you are doing as much as is practicable in reducing the risk of dementia or exacerbated brain volume loss.

Please remember that MS-UK gives support that can help with some of these brain-healthy lifestyle recommendations.

MS-UK can support you with exercise and activities, as well as creative and mentally stimulating services.

Leading a brain-healthy lifestyle is a positive step towards a healthier, longer life.

If you feel you are cognitively impaired and experiencing issues relating to memory, thinking and information processing, please speak to your MS team. They may well refer you for a cognitive assessment from a neuropsychologist or other member of your neuro-rehab team.

Do you need support?

If you’ve been affected by the topic of this piece, please call our helpline. Our helpline team are happy to support you with any concerns and answer any questions you might have. Call us free on 0800 783 0518, Monday-Friday, 10am-4pm. Alternatively, you can email us at info@ms-uk.org or send us a WhatsApp message.