Parkinson’s disease: A population-based investigation of life satisfaction and employment

Abstract

Objective: To investigate relationships between individuals' socioeconomic situations and quality of life in working-aged subjects with Parkinson's disease. Methods: A population-based cohort comprising 1,432 people with Parkinson's disease and 1,135 matched controls, who responded to a questionnaire. Logistic regression analysis was performed to identify factors associated with life satisfaction and likelihood of employment. Results: In multivariate analyses, Parkinson's disease was associated with an increased risk of dissatisfaction with life (odds ratio (OR) = 5.4, 95% confidence interval (95% CI) = 4.2-7.1) and reduced likelihood of employment (OR = 0.30, 95% CI = 0.25-0.37). Employers' support was associated with greater likelihood of employment (p < 0.001). Twenty-four percent of people with Parkinson's disease for ≥ 10 years remained employed and 6% worked full-time. People with Parkinson's disease also more frequently experienced work demands that exceeded their capacity; this factor and unemployment independently correlated with greater risk of dissatisfaction with life (both p < 0.05). Conclusion: People with Parkinson's disease have an increased risk of dissatisfaction with life. Employment situation is important for general life satisfaction among workingaged individuals. People with Parkinson's disease appear to find it difficult to meet the challenge of achieving a balanced employment situation.

Working capacity of patients with Parkinson's disease – A systematic review

“…These findings are consistent with several other included studies showing negative associations between age, disease duration and time in employment after disease onset [e.g. 12,14,15,18,19]. Two studies made a distinction between full-time and part-time employment.…”

“…The following results were found concerning part-time employment respectively: 24.3%, 23.5% and 18.2% [15]. In a sample of PD patients living in the UK with age-of-onset before 65 years and with a known employment history, full-and part-time employment rates were lower.…”

“…patients who used levodopa and entacapone worked longer post-diagnosis, retired less often and showed a lower annual medical absenteeism than patients who used entacapone and a placebo [23]. No study examined the effects of nonpharmacological treatments; only Gustafsson et al [15] reported that vocational rehabilitation might have a positive effect on the ability to work.…”

“…Also when taking a different approach by asking patients which symptoms affected their ability to work, motor symptoms were often mentioned. The most debilitating motor symptom according to patients is slowness (reported by 21%e45.8%), followed by stiffness (7.9%e47%), tremor (18%e38%), fine motor skills (25.6e30.8%), speech problems (11.0%), difficulties walking (9.3%) and poor balance (9.3% [15,16,22]). Consistent with these findings is a study showing that patients who retired because of PD reported a more severely impaired physical functioning and higher levels of bodily pain than employed patients [16].…”

“…Compared to healthy individuals, PD patients reported more often dissatisfaction with their work situation and experiencing work demands that exceed their abilities [15], which might lead to a decreased life satisfaction [15]. Furthermore, 23%e92% of patients reported that PD worsened their work capacity or that they retired early because of their disease [11e13,16].…”