How Does Personality Affect Cognition in MS?
Multiple sclerosis (MS) is a chronic disease that frequently leads to neurological symptoms and disabilities. The effects of MS can result in sensory changes, vision problems, mobility challenges, impaired control over bodily functions, cognitive dysfunction, and altered moods.
The cognitive challenges of MS, while quite common, can be particularly disturbing. More than half of all people with MS will develop problems with cognition, according to the National MS Society. Certain types of cognitive functions are more likely to be affected by MS than others, for example:
- Information processing (dealing with information gathered by the five senses)
- Memory (acquiring, retaining, and retrieving new information)
- Attention and concentration (particularly divided attention)
- Executive functions (planning and prioritizing)
- Visuospatial functions (visual perception and constructional abilities)
- Verbal fluency (word-finding)
If you have cognitive difficulties, you might notice problems in only one or two areas, or you might notice several problems. Certain functions, including general intelligence, long-term memory, conversational skill, and reading comprehension, are likely to be unaffected. However, cognitive dysfunction can interfere with the ability to remain employed, socially active, and independent.
Cognitive problems can affect people with any form of MS at any time; however, they are more common later in the disease and in people with progressive MS. Brain lesions and brain atrophy can affect cognition. Recent research suggests that personality can also affect cognitive functions.
Psychologists generally identify five overarching personality traits, including openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. In healthy adults, openness to experience is linked to better memory and protection from memory decline, while neuroticism is linked to poorer memory. Until recently, the connection between personality and memory impairment in persons diagnosed with MS had not been studied.
Published in the Multiple Sclerosis Journal, research funded in part by the National MS Society (NMSS) and the National Institutes of Health (NIH) aimed to investigate whether the consideration of personality traits — particularly openness and neuroticism — helps to explain problems with memory in people with MS. The personality trait of openness encompasses intellectual curiosity, aesthetic appreciation, and imagination and is positively correlated with intellect (IQ) and education.
Eighty people with MS participated in the study, including 64 diagnosed with relapsing–remitting MS, 12 with secondary progressive MS, and four with primary progressive MS. All participants underwent neuropsychological assessment and completed a personality trait test. Differences in personality traits were compared between patients with (n=27) and without (n=53) memory impairment.
Researchers found that openness was linked to lower risk for memory impairment. MS patients with memory impairment had lower openness and higher neuroticism, as well as lower conscientiousness, relative to patients without memory impairment. Higher openness and lower neuroticism predicted better memory in persons with MS, over and above the effects of education and IQ.
These findings were specific to memory only, with no links between other personality traits and non-memory cognitive functions.
In healthy adults, openness is linked to greater participation in cognitive, physical, and social activities, perhaps predisposing individuals to participate in stimulating activities that support cognitive reserve. In a posthoc analysis of 64 MS patients in this study, researchers found a relationship between higher openness and adulthood participation in a variety of enriching cognitive leisure activities, including fine arts, hobby activities, playing musical instruments, reading, and writing.
In contrast to openness, high neuroticism may be linked with a more cautious approach to the world and resistance to explore novel, enriching opportunities.
If you are concerned about cognitive dysfunction, talk to your neurologist. Because cognitive functions can also be affected by factors such as aging, medications, depression, anxiety, stress, and fatigue, a neuropsychologist or other specially trained health professional can administer a battery of tests to help determine the potential causes of any changes.
Treatment of cognitive dysfunction depends upon the cause, but research has shown that activities such as clinical pilates can improve cognitive functions. In addition, cognitive rehabilitation that teaches a combination of restorative and compensatory activities can be helpful. Based on the results of this small study, being open to new experiences may also help in staving off memory impairments.
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Leavitt VM, Buyukturkoglu K, Inglese M, et al. Protective personality traits: High openness and low neuroticism linked to better memory in multiple sclerosis. Mult Scler. 2017 Jan 1:1352458516685417. doi: 10.1177/1352458516685417. [Epub ahead of print]
Lisa Emrich is a patient advocate, accomplished speaker, author of the award-winning blog Brass and Ivory: Life with MS and RA, and founder of the Carnival of MS Bloggers. Lisa uses her experience to educate patients, raise disease awareness, encourage self-advocacy, and support patient-centered research. Lisa frequently works with non-profit organizations and has brought the patient voice to healthcare conferences and meetings worldwide. Follow Lisa on Facebook, Twitter, and Pinterest.