Employment Challenges in Parkinson's Disease are Associated With Financial Hardship and Reduced Quality of Life

Abstract

<h3>Research Objectives</h3> To explore the association between financial hardship, employment-related stressors, and quality of life in people with early Parkinson's disease (PD). <h3>Design</h3> This analysis uses baseline data from the Parkinson's disease: Intervening Early Concerning Employment (PIECE) study. PIECE is a prospective, longitudinal, observational study that will describe use of employment support resources in people with early PD over three years. <h3>Setting</h3> Remote research. <h3>Participants</h3> Of 101 people who were approached/referred, 87 were screened and 60 were enrolled. Participants live in the United States; are at least 18 years old; were diagnosed with PD in the past 5 years; and are currently employed, self-employed, or looking for work, and wish to remain employed for at least 3 years. People who do not speak English fluently are excluded. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> We measured financial hardship with a single item (5-point rating scale), financial toxicity with the Comprehensive Score for Financial Toxicity, and quality of life with the computer adapted NeuroQOL. We also collected Demographic, PD-related, and Employment Factors. <h3>Results</h3> Of the 60 participants, 23 (38%) reported a little bit and 14 (23%) reported somewhat or more hardship. The single-item financial hardship score was moderately correlated (ρ = -0.56) with comprehensive financial toxicity (mean ± SD, 22.0 ± 8.7, on a scale from 0-44), with lower scores indicating more financial toxicity. High financial hardship had a modest negative association with confidence in job retention and perceived workplace success. Financial hardship was also associated with poorer quality of life in five NeuroQOL domains: lower extremity function, satisfaction with social roles and activities, depression, anxiety, and stigma. All p < 0.05. <h3>Conclusions</h3> Financial hardship was common in people with early PD and was associated with both employment factors and quality of life. Further work should explore the effects of medical and psychosocial interventions to alleviate employment-related stressors in individuals with early PD. <h3>Author(s) Disclosures</h3> This work was funded by National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR: 90RTEM000101).