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20 December 2019

Intellectual enrichment and multiple sclerosis

Evidence shows that by continuing to take part in intellectually enriching leisure activities can reduce cognitive decline in people with MS.

Studies have shown that ‘intellectual enrichment’ activities can protect against loss of cognitive function that PwMS can get due to illness progression. This includes reading books and magazines, writing, playing a musical instrument, hobbies and structured games.

Lifetime intellectual enrichment and cognitive decline

Scientists from New Jersey displayed this in people with MS by using functional MRI. With the MRI, it is possible to view parts of the brain that are being used for certain activities, they demonstrated that people with MS with intellectual enrichment, that is those with higher educational level, vocabulary, etc (as a marker of how much use they used their brains), were protected against loss of cognitive function.

They showed that this involved the development of the brain’s default network, that is the parts of the brain not commonly used day-to-day, but used a lot in intellectual pursuits.

The research suggests that it may be possible to use ‘brain-training’ (cognitive strategy training) to minimise the impact of the cognitive decline that is usually seen with MS as the disease progresses. 

Effect of leisure activities on cognitive decline

This paper, published in Neurology, reports on a collaboration between researchers from New Jersey and Milan, involving 62 PwMS (41 relapsing-remitting and 21 secondary progressive). All apart from five were on MS medications.

The researchers investigated the decline in higher mental function that may accompany progressive MS disease activity, usually related to shrinkage of the brain over time with increasing numbers of lesions.

In this case, they investigated what they called cognitive leisure activities, that is intellectually enriching leisure activities, such as playing a musical instrument, keeping a diary or blog, having hobbies, maintaining a website, etc, and their effect on this cognitive decline.

While they found that brain shrinkage did predict the decline in higher mental function, they showed that those with the highest levels of intellectually enriching leisure activities were protected against this.

This is important information for PwMS. The OMS approach is to use whatever lifestyle changes we can to improve our chances of continuing good health.

While typically that is seen as involving diet, exercise, sun exposure, and so on, this research emphasises the importance of keeping involved in fulfilling activities that are stimulating and require intellectual effort.

This is doubly important in MS, because depression is so common with this illness, and once people are depressed, they are much less likely to continue with these intellectually enriching daily activities.

Being proactive – through diet, omega 3 supplements, exercise and meditation helps maintain the positive attitude to keep doing intellectually enriching activities and hobbies. Similarly, doing these activities helps avoid depression.

So this is a highly beneficial positive feedback loop that feeds on itself to keep PwMS optimistic, positive and cognitively sharp. For those not keeping a diary, which we strongly recommend at OMS, this might be a good time to consider starting one.

Other activities like art, music, reading, etc also seem to have the same beneficial effects. The authors conclude the Abstract of the paper by saying:

“Lifestyle choices protect against cognitive impairment independently of genetic factors outside of one’s control.”