How to Treat Multiple System Atrophy (MSA)

How to Treat Multiple System Atrophy (MSA)

Multiple system atrophy (MSA) is a rare neurological condition with symptoms that affect your blood pressure, muscle control, and other bodily functions. While scientists and researchers are still seeking a cure for MSA, there are a lot of treatments and therapies that can help you manage symptoms and maintain as much autonomy as possible. If you receive an MSA diagnosis, you’ll have a large team of specialists to help you develop the best care plan for your individual situation.[1] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source

Method 1 of 4:
Getting a Diagnosis

1
Talk to your doctor if you develop symptoms of MSA. If you feel like you or someone you love might have MSA, getting to a doctor as soon as possible is really important. It may feel scary, but there are things your doctor can do to help you feel more comfortable. [2] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Common symptoms of MSA include rigid muscles, slow movement, tremors, difficulty bending your limbs, loss of balance, disturbed speech patterns, visual disturbances, and problems with posture and balance. There are other symptoms that you may experience. For a more comprehensive list, visit https://www.mayoclinic.org/diseases-conditions/multiple-system-atrophy/symptoms-causes/syc-20356153.
2
Prepare a list of questions to ask your doctor. It can be overwhelming to try and remember everything you want to ask when you’re in an appointment, and writing things down ahead of time can help make sure you don’t forget anything. Here are some questions you may want to ask your doctor: [3] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source What other potential things could be causing my symptoms? What kinds of tests will you want me to do? How do you make a diagnosis? What does treatment for MSA look like? What can I do in the meantime to manage my symptoms?
3
Get tested to determine if the cause of your symptoms is MSA. The symptoms of MSA can mimic symptoms of several other conditions, like Parkinson’s disease. Your doctor may run several tests, like a blood test, a physical examination, and perhaps an MRI. Here are some other tests your doctor may perform, depending on your symptoms: [4] X Research source Your doctor may monitor your blood pressure and heart rate while you’re moved on a motorized table to see if there are blood pressure irregularities. Your doctor may perform a sweat test to measure and evaluate how much you perspire. There may be a test done to observe your bladder and bowels. Your doctor may run an electrocardiogram to test your heart. A sleep test might be ordered if you’re having trouble sleeping.

Tip: Ask a friend or family member to attend your doctor’s appointments with you. This is a stressful time for you, and it’ll be helpful to have emotional support, as well as a second pair of ears to hear what the doctor has to say.[5] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source

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Method 2 of 4:
Working with Specialists

1
Find a neurologist who specializes in MSA. If you receive a diagnosis, a neurologist will be an important part of your care team moving forward. You’ll be meeting with them regularly for checkups, as well as if anything unexpected happens with your health. You could ask your family doctor for some recommendations and meet with several neurologists before choosing the one you want to work with. [6] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source MSA can be difficult to diagnose since there isn’t one definitive test that can say if you have it or not. Your doctor will most likely say you have “possible” MSA or “probable” MSA. Regardless, it’ll be important for you to get special treatment to manage your symptoms.
2
Work on swallowing and speech functions with a speech-language pathologist. Slurred speech, slowed speech, and difficulty swallowing are common symptoms of MSA. A speech-language pathologist can help you develop some new skills to combat these symptoms and delay more intrusive treatments. [7] X Trustworthy Source Johns Hopkins Medicine Official resource database of the world-leading Johns Hopkins Hospital Go to source Your doctor or neurologist may also recommend you see a laryngologist, someone who specializes in illnesses that affect your larynx. Everyone who has MSA experiences symptoms a little differently. You may not have any speech or swallowing problems, or that may be the main issue you’re dealing with. Work with your doctors to develop a care plan that’s best for your needs.
3
Visit a physical therapist regularly to work on maintaining your fine motor skills. Getting diagnosed with MSA can be scary, and you may be worried about how you’re going to manage as your condition progresses. Be proactive and work with a physical therapist who specializes in these types of conditions. [8] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source People with MSA often experience changes to their balance or how they walk; a physical therapist can help you make adjustments so you can stay mobile for as long as possible.
4
Hire an occupational therapist if you need help with your day-to-day activities. If your MSA is effecting how safely you’re able to get dressed, go to the bathroom, feed yourself, or do other tasks, an occupational therapist may help relieve some of that stress for you. They can also help you learn how to do things differently if you find you need a wheelchair or a walker. [9] X Research source Getting an occupational therapist can be a really hard transition for many people. It’s a huge change in your life, so be patient with yourself. It’s okay if you feel angry, embarrassed, resentful, or scared.
5
Consider seeing a therapist to talk about the emotional impact of MSA. Receiving an MSA diagnosis brings a lot of physical challenges and changes, but it also can be really hard to deal with emotionally. A therapist who specializes in chronic illnesses may be able to provide you with some support as you process everything that’s changing. [10] X Trustworthy Source FamilyDoctor.org Family-focused medical advice site run by the American Academy of Family Doctors Go to source If you have a family, you may also want to consider family counseling. MSA is something that affects you and those around you. It can be stressful and scary for everyone.
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Method 3 of 4:
Using Mediations and Medical Procedures

1
Take blood pressure medication to keep your BP at a normal rate. If you have MSA, your blood pressure may tend to go too low or may fluctuate throughout the day. Your doctor will most likely need to try out a few combinations of medications to find the right fit for you. Make sure to always follow their instructions carefully and take your medicine when you’re supposed to. [11] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source With MSA, your blood pressure may change depending on whether you’re standing, sitting, or laying down. Low blood pressure is one of the more common symptoms of MSA, which may get worse when you stand up.
2
Talk to your doctor about taking Parkinson’s medications. Depending on your symptoms, this may be an option for you. However, the medications used to treat Parkinson’s can sometimes become less effective over time for people with MSA or they may not treat the specific symptoms you’re experiencing. [12] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Everyone with MSA experiences symptoms a little differently. Make sure to share everything with your doctor about how you’re feeling so you can come up with the most effective care plan.
3
Talk with your doctor if you start having any bladder issues. MSA can affect your muscles and cause incontinence. This can feel embarrassing, but talking to your doctor can help you come up with a plan so you can maintain as much autonomy as possible. There are medications you can take, and your physical therapist may also be able to help you. [13] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source As your MSA progresses, your doctor may encourage you to get a catheter.
4
Get injections to help manage dystonia (abnormal muscle postures). MSA can cause your muscles to contract or cramp, resulting sometimes in a painful or awkward posture. Some injections, like botulinum toxin, can help. There are also some medications and therapies you can use to help with these symptoms. [14] X Research source Talk to your doctor about any new cramps, repetitive movements, or experiences you have.
5
Consider a pacemaker if your blood pressure keeps dropping too low. If you are consistently struggling with low blood pressure, your doctor may recommend a pacemaker. Once it’s installed, it’ll help your heart beat a little faster, which in turn should keep your blood pressure up. [15] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Chances are, your doctor will want you to try medications before moving to a pacemaker. But if it’s something you think will be beneficial, you should definitely ask about it.
6
Have a feeding tube implanted if you can no longer swallow. At a certain stage, your doctor may recommend a feeding or gastrostomy tube. While the feeding tube can eliminate the risk of choking and make it possible for you to get the nutrients you need, losing the ability to chew, swallow, or feed yourself will be a huge adjustment. [16] X Research source It can be overwhelming to learn how to manage your MSA. Having a friend or family member who can help will be really important.
7
Look into joining a clinical trial to test out new treatments for MSA. Unfortunately, there’s currently no cure for MSA. Clinical trials are constantly researching new treatments and interventions to slow down the progression of MSA and hopefully find a cure. [17] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source If you’re interested in participating in a trial test, talk to your doctor.
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Method 4 of 4:
Making Lifestyle Changes

1
Eat softer foods if you have trouble swallowing. It can be a little challenging to find foods that you love while making sure they’re safe to eat, but there are a lot of options for soft meals that you may enjoy. Fruit smoothies are a great option and can provide you with tons of minerals and vitamins, yogurt is a good source of dairy, and pureed soups can provide a lot of flavor and nutrients. [18] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Depending on your individual situation, you may be able to eat things like scrambled eggs, crustless quiche, tuna salad, couscous, meatloaf, or banana bread, too.
2
Increase your blood pressure naturally with added salt and caffeine. While most diets recommend that you reduce your salt intake and limit how much caffeine you consume, you may actually benefit from these things. Salt and caffeine both increase blood pressure, so add some salt to your meals, drink an extra cup of coffee, or keep your favorite soda stocked in the fridge. [19] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Talk to your doctor first to make sure it’s safe for you to add salt and caffeine to your diet. Depending on your medical or medication history, they may recommend something else.
3
Elevate the head of your bed and be careful going from sitting to standing. Keeping your body slightly elevated while you’re sleeping will help your blood pressure stay in the right range. When you do get up from laying down or sitting, do so slowly. If you jump up too quickly, your blood pressure could drop and you may get dizzy. [20] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Try to angle the top of your bed at about 30 degrees. Test it out and make any adjustments so you’re as comfortable as possible.
4
Use compression stockings to help control your blood pressure. This type of stocking reduces how much blood is pooling in your legs, which then positively impacts how hard your heart has to work. If your doctor recommends compression stockings, you’ll most likely want to wear them every day. [21] X Research source Compression stockings can be a little difficult to get on because they’re meant to be a bit tight, especially around your feet and ankles. If you have trouble bending over, ask someone to help you.
5
Add more fiber to your diet to keep your bowel movements regular. You may also want to take a fiber supplement if you start experiencing constipation. Drinking extra water can also help with preventing constipation. [22] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source In general, women should aim for 21-25 grams of fiber each day; men should try to get 30-38 grams each day. Talk to your doctor to make sure these figures are right for you.[23] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source

High-Fiber Foods: Focus on eating lots of whole foods, like fruits, vegetables, whole-wheat grains, legumes, and seeds. Pears and raspberries have lots of fiber in them, as do peas, broccoli, lentils, and chia seeds.[24] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source

6
Eat small meals throughout the day to help manage your blood pressure. Small meals will help keep your body nourished throughout the day and are easier to digest than large, heavy meals. It may also take you longer to eat, so small meals will be more manageable. [25] X Research source As your condition progresses, it may become harder to cut up food, feed yourself, chew, or swallow. This can be hard to accept and mealtime can often become a source of stress if you have MSA. Focus on getting in some important nutrients at each meal, like protein and fiber. Talk to your doctor or occupational therapist if eating is becoming increasingly difficult.
7
Avoid getting overheated and cool down quickly if you get too warm. MSA can impact your body’s ability to sweat and cool itself off. Stay indoors on really warm days, and try to not get too hot while you’re showering, walking, or doing other activities. [26] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Getting too hot could affect your blood pressure or cause heat exhaustion. If you get too hot, stop moving and rest. Get to an air-conditioned space as soon as possible. You could also place cold, wet washcloths on your wrists, forehead, and back of your neck.
8
Play cognitive games to help your mental processing stay sharp. Some forms of MSA can impact your verbal skills, attention span, or memory. Spend some time each day working on puzzles, sudoku, crossword puzzles, word searches, trivia games, chess, or board games. [27] X Research source There are some great apps you can download to your phone or a tablet. Lumosity, CogniFit Brain Fitness, BrainHQ, and Cogmed have great reviews.[28] X Research source
Advertisement

Method 1 of 4:
Getting a Diagnosis

1
Talk to your doctor if you develop symptoms of MSA. If you feel like you or someone you love might have MSA, getting to a doctor as soon as possible is really important. It may feel scary, but there are things your doctor can do to help you feel more comfortable. [2] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Common symptoms of MSA include rigid muscles, slow movement, tremors, difficulty bending your limbs, loss of balance, disturbed speech patterns, visual disturbances, and problems with posture and balance. There are other symptoms that you may experience. For a more comprehensive list, visit https://www.mayoclinic.org/diseases-conditions/multiple-system-atrophy/symptoms-causes/syc-20356153.
2
Prepare a list of questions to ask your doctor. It can be overwhelming to try and remember everything you want to ask when you’re in an appointment, and writing things down ahead of time can help make sure you don’t forget anything. Here are some questions you may want to ask your doctor: [3] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source What other potential things could be causing my symptoms? What kinds of tests will you want me to do? How do you make a diagnosis? What does treatment for MSA look like? What can I do in the meantime to manage my symptoms?
3
Get tested to determine if the cause of your symptoms is MSA. The symptoms of MSA can mimic symptoms of several other conditions, like Parkinson’s disease. Your doctor may run several tests, like a blood test, a physical examination, and perhaps an MRI. Here are some other tests your doctor may perform, depending on your symptoms: [4] X Research source Your doctor may monitor your blood pressure and heart rate while you’re moved on a motorized table to see if there are blood pressure irregularities. Your doctor may perform a sweat test to measure and evaluate how much you perspire. There may be a test done to observe your bladder and bowels. Your doctor may run an electrocardiogram to test your heart. A sleep test might be ordered if you’re having trouble sleeping.

Tip: Ask a friend or family member to attend your doctor’s appointments with you. This is a stressful time for you, and it’ll be helpful to have emotional support, as well as a second pair of ears to hear what the doctor has to say.[5] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source

Advertisement

Method 2 of 4:
Working with Specialists

1
Find a neurologist who specializes in MSA. If you receive a diagnosis, a neurologist will be an important part of your care team moving forward. You’ll be meeting with them regularly for checkups, as well as if anything unexpected happens with your health. You could ask your family doctor for some recommendations and meet with several neurologists before choosing the one you want to work with. [6] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source MSA can be difficult to diagnose since there isn’t one definitive test that can say if you have it or not. Your doctor will most likely say you have “possible” MSA or “probable” MSA. Regardless, it’ll be important for you to get special treatment to manage your symptoms.
2
Work on swallowing and speech functions with a speech-language pathologist. Slurred speech, slowed speech, and difficulty swallowing are common symptoms of MSA. A speech-language pathologist can help you develop some new skills to combat these symptoms and delay more intrusive treatments. [7] X Trustworthy Source Johns Hopkins Medicine Official resource database of the world-leading Johns Hopkins Hospital Go to source Your doctor or neurologist may also recommend you see a laryngologist, someone who specializes in illnesses that affect your larynx. Everyone who has MSA experiences symptoms a little differently. You may not have any speech or swallowing problems, or that may be the main issue you’re dealing with. Work with your doctors to develop a care plan that’s best for your needs.
3
Visit a physical therapist regularly to work on maintaining your fine motor skills. Getting diagnosed with MSA can be scary, and you may be worried about how you’re going to manage as your condition progresses. Be proactive and work with a physical therapist who specializes in these types of conditions. [8] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source People with MSA often experience changes to their balance or how they walk; a physical therapist can help you make adjustments so you can stay mobile for as long as possible.
4
Hire an occupational therapist if you need help with your day-to-day activities. If your MSA is effecting how safely you’re able to get dressed, go to the bathroom, feed yourself, or do other tasks, an occupational therapist may help relieve some of that stress for you. They can also help you learn how to do things differently if you find you need a wheelchair or a walker. [9] X Research source Getting an occupational therapist can be a really hard transition for many people. It’s a huge change in your life, so be patient with yourself. It’s okay if you feel angry, embarrassed, resentful, or scared.
5
Consider seeing a therapist to talk about the emotional impact of MSA. Receiving an MSA diagnosis brings a lot of physical challenges and changes, but it also can be really hard to deal with emotionally. A therapist who specializes in chronic illnesses may be able to provide you with some support as you process everything that’s changing. [10] X Trustworthy Source FamilyDoctor.org Family-focused medical advice site run by the American Academy of Family Doctors Go to source If you have a family, you may also want to consider family counseling. MSA is something that affects you and those around you. It can be stressful and scary for everyone.
Advertisement

Method 3 of 4:
Using Mediations and Medical Procedures

1
Take blood pressure medication to keep your BP at a normal rate. If you have MSA, your blood pressure may tend to go too low or may fluctuate throughout the day. Your doctor will most likely need to try out a few combinations of medications to find the right fit for you. Make sure to always follow their instructions carefully and take your medicine when you’re supposed to. [11] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source With MSA, your blood pressure may change depending on whether you’re standing, sitting, or laying down. Low blood pressure is one of the more common symptoms of MSA, which may get worse when you stand up.
2
Talk to your doctor about taking Parkinson’s medications. Depending on your symptoms, this may be an option for you. However, the medications used to treat Parkinson’s can sometimes become less effective over time for people with MSA or they may not treat the specific symptoms you’re experiencing. [12] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Everyone with MSA experiences symptoms a little differently. Make sure to share everything with your doctor about how you’re feeling so you can come up with the most effective care plan.
3
Talk with your doctor if you start having any bladder issues. MSA can affect your muscles and cause incontinence. This can feel embarrassing, but talking to your doctor can help you come up with a plan so you can maintain as much autonomy as possible. There are medications you can take, and your physical therapist may also be able to help you. [13] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source As your MSA progresses, your doctor may encourage you to get a catheter.
4
Get injections to help manage dystonia (abnormal muscle postures). MSA can cause your muscles to contract or cramp, resulting sometimes in a painful or awkward posture. Some injections, like botulinum toxin, can help. There are also some medications and therapies you can use to help with these symptoms. [14] X Research source Talk to your doctor about any new cramps, repetitive movements, or experiences you have.
5
Consider a pacemaker if your blood pressure keeps dropping too low. If you are consistently struggling with low blood pressure, your doctor may recommend a pacemaker. Once it’s installed, it’ll help your heart beat a little faster, which in turn should keep your blood pressure up. [15] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Chances are, your doctor will want you to try medications before moving to a pacemaker. But if it’s something you think will be beneficial, you should definitely ask about it.
6
Have a feeding tube implanted if you can no longer swallow. At a certain stage, your doctor may recommend a feeding or gastrostomy tube. While the feeding tube can eliminate the risk of choking and make it possible for you to get the nutrients you need, losing the ability to chew, swallow, or feed yourself will be a huge adjustment. [16] X Research source It can be overwhelming to learn how to manage your MSA. Having a friend or family member who can help will be really important.
7
Look into joining a clinical trial to test out new treatments for MSA. Unfortunately, there’s currently no cure for MSA. Clinical trials are constantly researching new treatments and interventions to slow down the progression of MSA and hopefully find a cure. [17] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source If you’re interested in participating in a trial test, talk to your doctor.
Advertisement

Method 4 of 4:
Making Lifestyle Changes

1
Eat softer foods if you have trouble swallowing. It can be a little challenging to find foods that you love while making sure they’re safe to eat, but there are a lot of options for soft meals that you may enjoy. Fruit smoothies are a great option and can provide you with tons of minerals and vitamins, yogurt is a good source of dairy, and pureed soups can provide a lot of flavor and nutrients. [18] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Depending on your individual situation, you may be able to eat things like scrambled eggs, crustless quiche, tuna salad, couscous, meatloaf, or banana bread, too.
2
Increase your blood pressure naturally with added salt and caffeine. While most diets recommend that you reduce your salt intake and limit how much caffeine you consume, you may actually benefit from these things. Salt and caffeine both increase blood pressure, so add some salt to your meals, drink an extra cup of coffee, or keep your favorite soda stocked in the fridge. [19] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Talk to your doctor first to make sure it’s safe for you to add salt and caffeine to your diet. Depending on your medical or medication history, they may recommend something else.
3
Elevate the head of your bed and be careful going from sitting to standing. Keeping your body slightly elevated while you’re sleeping will help your blood pressure stay in the right range. When you do get up from laying down or sitting, do so slowly. If you jump up too quickly, your blood pressure could drop and you may get dizzy. [20] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Try to angle the top of your bed at about 30 degrees. Test it out and make any adjustments so you’re as comfortable as possible.
4
Use compression stockings to help control your blood pressure. This type of stocking reduces how much blood is pooling in your legs, which then positively impacts how hard your heart has to work. If your doctor recommends compression stockings, you’ll most likely want to wear them every day. [21] X Research source Compression stockings can be a little difficult to get on because they’re meant to be a bit tight, especially around your feet and ankles. If you have trouble bending over, ask someone to help you.
5
Add more fiber to your diet to keep your bowel movements regular. You may also want to take a fiber supplement if you start experiencing constipation. Drinking extra water can also help with preventing constipation. [22] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source In general, women should aim for 21-25 grams of fiber each day; men should try to get 30-38 grams each day. Talk to your doctor to make sure these figures are right for you.[23] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source

High-Fiber Foods: Focus on eating lots of whole foods, like fruits, vegetables, whole-wheat grains, legumes, and seeds. Pears and raspberries have lots of fiber in them, as do peas, broccoli, lentils, and chia seeds.[24] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source

6
Eat small meals throughout the day to help manage your blood pressure. Small meals will help keep your body nourished throughout the day and are easier to digest than large, heavy meals. It may also take you longer to eat, so small meals will be more manageable. [25] X Research source As your condition progresses, it may become harder to cut up food, feed yourself, chew, or swallow. This can be hard to accept and mealtime can often become a source of stress if you have MSA. Focus on getting in some important nutrients at each meal, like protein and fiber. Talk to your doctor or occupational therapist if eating is becoming increasingly difficult.
7
Avoid getting overheated and cool down quickly if you get too warm. MSA can impact your body’s ability to sweat and cool itself off. Stay indoors on really warm days, and try to not get too hot while you’re showering, walking, or doing other activities. [26] X Trustworthy Source Mayo Clinic Educational website from one of the world's leading hospitals Go to source Getting too hot could affect your blood pressure or cause heat exhaustion. If you get too hot, stop moving and rest. Get to an air-conditioned space as soon as possible. You could also place cold, wet washcloths on your wrists, forehead, and back of your neck.
8
Play cognitive games to help your mental processing stay sharp. Some forms of MSA can impact your verbal skills, attention span, or memory. Spend some time each day working on puzzles, sudoku, crossword puzzles, word searches, trivia games, chess, or board games. [27] X Research source There are some great apps you can download to your phone or a tablet. Lumosity, CogniFit Brain Fitness, BrainHQ, and Cogmed have great reviews.[28] X Research source
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