MS and cognition and early Cardiovascular Disease

Multiple sclerosis is a lifelong disease with genetic and environmental influences.

The clinical symptoms and progression of symptoms vary between individuals.

Leg weakness and ambulatory difficulties predominate in patient’s minds and are the most difficult problem for some.

Other patients will struggle with cognitive abilities and fatigue.

 Disease modifying therapy has been demonstrated to prevent acute relapses which has helped with progression of motor disability scores at least in short term.

 It is important, however, to still modify other environmental factors.

We all need to exercise, sleep well, keep down our weight but also keep down modifiable cardiovascular risk factors even early in life.

 A study published in Neurology this week, CARDIA Study, showed that cardiovascular disease in people < 60 yr of age was associated with worse midlife cognition and white matter health. The study included 3,148 participants, mean age 55, 57% women and 48% black. They adjusted for education, income, depression, diet and APOE and still found association with lower cognition in 4/5 domains..

 Since we know that our multiple sclerosis patients have some accelerated cognitive problems, we need to make sure they also keep down any other factors that will add to that process.

That includes cardiovascular risks, hypertension, cholesterol, peripheral vascular disease.

 We all need to try our best to maintain our brain health

Nancy Nealon, MD

Weill Cornell Medicine Multiple Sclerosis Center 1305 York Ave., Second Floor New York, NY 10021