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MS research update – Can memory aids help with memory problems in MS? – 30 November 2015

Summary

This study reviewed the previous research into the use of external memory aids, such as diaries and calendars in people with MS to see if they could help with memory problems.

The analysis showed that there were some benefits from external memory aids. However the results were mixed and as there were so many types of intervention trialled that it is difficult to compare the studies directly with each other or to draw any conclusions as to what exactly are the best approaches or components for improving memory.

The study shows that currently there is insufficient evidence to definitely say if external memory aids are effective or not for memory problems in MS. The researchers conclude that better designed studies would be needed to test if external memory aids could help with memory problems for people with MS

Background

About half of all people with MS have problems at some time with aspects of thinking (cognition) such as memory, concentration or problem solving. Memory difficulties can have a big impact of daily life. In MS memory problems are often related to the recall of recent events or information and forgetting to carry out planned actions in the future.

There are various strategies and gadgets that can help lessen the impact of memory problems. External memory aids are those things that are external to you, so often objects and gadgets such as lists, sticky notes, diaries and calendars, which remind you to do things or help you remember something. Internal memory aids are ways of thinking about something to help you remember, such as mental imagery (building up a picture of something in your mind), mnemonics (such as rhymes or linking things together) or repeating the information over and over in your head to help you remember it.

In people who have had a stroke or a brain injury there is good evidence that external memory aids can help reduce the impact of memory problems. This study reviewed the existing research to see if these sorts of aids can also help people with MS.

How this study was carried out

This study was a review which pooled the previous research into the use of external memory aids in people with MS. External memory aids were defined as any external means of compensating for a memory problem such as a diary, personal digital assistant (PDA) or calendar.

To be included in the review the studies needed to only involve people with MS or include a group of participants with MS where their results were available separately. The included studies also had evaluate how effective a particular intervention was, such as were there any improvements in memory, mood or quality of life for those participants using or being trained in the use of an external memory aid.

Nine studies, including 540 participants, met the criteria and were included in the analysis. Six studies were form Europe and three from the USA. Eight of the studies involved a comprehensive cognitive or memory rehabilitation programme where participants were taught to use external memory aids as well as other memory strategies such as learning techniques to help recall information.

What was found

The review found that there were some benefits from external memory aids. One study found that using them improved participants memory function, two found an improvement in mood and another two improved participants coping strategies for dealing with their memory problems.

However the results were mixed and the details given about the studies lacked lots of information to determine exactly how the studies were carried out. Additionally as there were so many types of intervention trialled that it is difficult to compare the studies directly with each other or to draw any conclusions as to what exactly are the best approaches or components for improving memory.

What does it mean?

The study shows that currently there is insufficient evidence to definitely say if external memory aids are effective or not for memory problems in MS. The researchers do highlight that the current level of evidence is poor: the existing studies have not been well designed to test the approaches, they do not describe how they were carried out in detail, and most were testing several different approaches at once, not just looking at using memory aids in isolation. The researchers conclude that better designed studies would be needed to test if external memory aids could help with memory problems for people with MS

Goodwin R, Lincoln N, das Nair R, Bateman A.
External memory aids for memory problems in people with multiple sclerosis: a systematic review.
Neuropsychol Rehabil. 2015 Nov 26:1-22. [Epub ahead of print]
Abstract

More about memory and other cognitive symptoms

Cognitive difficultiesis the term used to describe a range of problems with slowed thinking such as poor memory, attention span or concentration and difficulty following complicated instructions or problem solving. Cognitive symptoms are common in MS but may not be recognised. Management of these symptoms involves finding strategies that minimise the difficulty, for example, if you have trouble remembering where you've put your car keys, always putting them in the same place will help.

There is more information, tips and strategies for getting around cognitive symptoms including memory problems on the StayingSmart website. StayingSmart was developed by the MS Trust in partnership with Prof Dawn Langdon, a neuropsychologist at Royal Holloway University of London. The Tips and Tricks section, which includes ideas shared by people living with cognitive symptoms, and Gadgets and Gizmos features readily available items of equipment that may be helpful.

You can also read more about cognition and MS in the A to Z of MS.

Research by topic areas...

Assessment tools

Ghezzi A, Mutta E, Bianchi F, et al.
Diagnostic tools for assessment of urinary dysfunction in MS patients without urinary disturbances.
Neurol Sci. 2015 Nov 27. [Epub ahead of print]
Abstract

Hansen S, Muenssinger J, Kronhofmann S, et al.
Cognitive screening tools in multiple sclerosis revisited: sensitivity and specificity of a short version of Rao's Brief Repeatable Battery.
BMC Neurol. 2015 Nov 26;15(1):246.
Abstract
Read the full text of this paper

Carers

Lee EJ, Pieczynski J, DeDios-Stern S, et al.
Gender differences in caregiver strain, needs for support, social support, and quality of life among spousal caregivers of persons with multiple sclerosis.
Work. 2015 Nov 24. [Epub ahead of print]
Abstract

Diagnosis

Kantarci OH, Lebrun C, Siva A, et al.
Primary progressive MS evolving from radiologically isolated syndrome.
Ann Neurol. 2015 Nov 24. [Epub ahead of print]
Abstract

Muris AH, Rolf L, Broen K, et al.
A low vitamin D status at diagnosis is associated with an early conversion to secondary progressive multiple sclerosis.
J Steroid Biochem Mol Biol. 2015 Nov 17. [Epub ahead of print]
Abstract

Tur C, Thompson AJ.
Early accurate diagnosis crucial in multiple sclerosis.
Practitioner. 2015 Sep;259(1785):21-7, 2-3.
Abstract

Disease modifying drugs

Pavlovic D, Patera AC, Nyberg F, et al.
Progressive multifocal leukoencephalopathy: current treatment options and future perspectives.
Ther Adv Neurol Disord. 2015 Nov;8(6):255-273. Review.
Abstract
Read the full text of this paper

Other

Thalheim C.
Pooling real-world multiple sclerosis patient data on a European level: a true story of success.
Neurodegener Dis Manag. 2015 Dec;5(6s):55-58.
Abstract
Read the full text of this paper

Other treatments

Paolicelli D, Direnzo V, Manni A, et al.
Long-term data of efficacy, safety and tolerability in a real life setting of THC/CBD oromucosal spray-treated multiple sclerosis patients.
J Clin Pharmacol. 2015 Nov 26. [Epub ahead of print]
Abstract

Paediatric MS

Salzer J, Lycke J, Wickström R, et al.
Rituximab in paediatric onset multiple sclerosis: a case series.
J Neurol. 2015 Nov 24. [Epub ahead of print]
Abstract

Physical activity

Peterson D, Huisinga JM, Spain R, et al.
Characterization of compensatory stepping in people with multiple sclerosis.
Arch Phys Med Rehabil. 2015 Nov 18. [Epub ahead of print]
Abstract

Rehabilitation

Fong MW, Lee EJ, Sheppard-Jones K, et al.
Home functioning profiles in people with multiple sclerosis and their relation to disease characteristics and psychosocial functioning.
Work. 2015 Nov 24. [Epub ahead of print]
Abstract

Haselkorn JK, Hughes C, Rae-Grant A, et al.
Summary of comprehensive systematic review: rehabilitation in multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.
Neurology. 2015 Nov 24;85(21):1896-903.
Abstract
Read the full text of this paper

Symptoms and symptom management

Fox RJ, Bacon TE, Chamot E, et al.
Prevalence of multiple sclerosis symptoms across lifespan: data from the NARCOMS Registry.
Neurodegener Dis Manag. 2015 Dec;5(6s):3-10.
Abstract
Read the full text of this paper

Šabanagić-Hajrić S, Suljić E, Kučukalić A.
Fatigue during multiple sclerosis relapse and its relationship to depression and neurological disability.
Psychiatr Danub. 2015 Dec;27(4):406-412.
Abstract
Read the full text of this paper (PDF)

Kennelly M, Dmochowski R, Schulte-Baukloh H, et al.
Efficacy and safety of onabotulinumtoxinA therapy are sustained over 4 years of treatment in patients with neurogenic detrusor overactivity: final results of a long-term extension study.
Neurourol Urodyn. 2015 Nov 24. [Epub ahead of print]
Abstract
Read the full text of this paper

Braley TJ, Chervin RD.
A practical approach to the diagnosis and management of sleep disorders in patients with multiple sclerosis.
Ther Adv Neurol Disord. 2015 Nov;8(6):294-310. Review.
Abstract
Read the full text of this paper

Work

Li J, Fitzgerald SM, Bishop M, et al.
Disease-related and functional predictors of employment status among adults with multiple sclerosis.
Work. 2015 Nov 24. [Epub ahead of print]
Abstract

Chiu CY, Chan F, Edward Sharp S, et al.
Employment as a health promotion intervention for persons with multiple sclerosis.
Work. 2015 Nov 24. [Epub ahead of print]
Abstract

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