Abstract
BackgroundCognitive functioning has been linked to employment outcomes in multiple sclerosis (MS) in cross-sectional studies. Longitudinal studies are however lacking and previous studies did not extensively examine executive functioning.ObjectivesWe examined whether baseline cognitive functioning predicts a change in employment status after 2 years, while taking into account mood, fatigue and disability level.MethodsA total of 124 patients with relapsing-remitting MS (pwMS) and 60 healthy controls were included. They underwent neurological and neuropsychological examinations and completed online questionnaires. PwMS were divided into a stable and deteriorated employment status group (SES and DES), based on employment status 2 years after baseline. We first examined baseline differences between the SES and DES groups in cognitive functioning, mood, fatigue and disability level. A logistic regression analysis was performed, with change in employment status (SES/DES) as dependent variable.ResultsThe DES group included 22% pwMS. Group differences were found in complex attention, executive functioning, self-reported cognitive functioning, fatigue and physical disability. More physical disability (OR = 1.90, p = 0.01) and lower executive functioning (OR = 0.30, p = 0.03) were retained as independent predictors of DES (R2 = 0.22, p ≤ 0.001).ConclusionsBaseline physical disability and executive functioning, but none of the other variables, moderately predicted a deterioration in employment status 2 years later.Trial registrationThis observational study is registered under NL43098.008.12: ‘Voorspellers van arbeidsparticipatie bij mensen met relapsing-remitting Multiple Sclerose’. This study is registered at the Dutch CCMO register (https://www.toetsingonline.nl).
Highlights
Work participation plays an important role in our lives and is often linked to quality of life
This longitudinal study shows that patients with multiple sclerosis (pwMS) who deteriorated in employment status after 2 years due to multiple sclerosis (MS) showed lower executive functioning, more self-reported cognitive problems, more symptoms of depression, higher fatigue and higher physical disability at baseline
The current study revealed that lower executive functioning and more physical disability are moderately predictive of a deterioration in employment status after 2 years due to MS
Summary
Work participation plays an important role in our lives and is often linked to quality of life. Extended author information available on the last page of the article challenging to meet the demands of working life. Work participation is often compromised in patients with multiple sclerosis (pwMS) with unemployment rates up to 80% [2]. In those who remain in the workforce, a reduction in hours or work responsibilities, presenteeism and increased time missed from work is often observed [3]. Cognitive functioning has been linked to employment outcomes in multiple sclerosis (MS) in cross-sectional studies. Longitudinal studies are lacking and previous studies did not extensively examine executive functioning
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