Predictors of unemployment status in people with relapsing multiple sclerosis: a single center experience

Abstract

Background Multiple sclerosis (MS) is the most common cause of nontraumatic chronic neurological disability affecting young adults during their crucial employment years. Objectives To evaluate patients and disease related factors associated to unemployment in a cohort of relapsing–remitting (RR) MS patients. Methods We included RRMS patients with a follow-up of at least 1 year. We collected data about years of school education and employment status. Patients underwent a neuropsychological evaluation using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Demographic and clinical predictors of unemployment were assessed through a multivariable stepwise logistic regression model. Results We evaluated 260 consecutive RRMS patients. Employed patients were less frequently female (68.4% vs 83.3%, p = 0.006), less disabled (median Expanded Disability Status Scale (EDSS) score: 2.0 (0–7.0) vs 2.5 (0–7.5), p < 0.001), with more years of school education (mean ± standard deviation (SD), years: 13.74 ± 0.30 vs 10.86 ± 3.47, p < 0.001). Female sex and a higher EDSS score resulted associated with a greater risk of unemployment (OR 3.510, 95% CI 1.654–7.448, p = 0.001; OR 1.366, 95% CI 1.074–1.737, p = 0.011, respectively), whereas a greater number of years of schooling and current disease-modifying therapy exposure resulted protective factors (OR 0.788, 95% CI 0.723–0.858, p < 0,001; OR 0.414, 95% CI 0.217–0.790, p = 0.008, respectively). Conclusions Understanding work is pervasively influenced by consequences of MS, we confirmed the impact of demographic, physical, and cognitive factors on employment status in RRMS patients.

Contextual Factors Matter: The Role of Social Support in Work-Related Difficulties and Employment Status in Persons with Multiple Sclerosis

“…When conducting statistical models, it was considered relevant to incorporate education, depression, and SDMT, as they also showed differences between employed and unemployed PwMS groups and were reported in the previous literature as relevant to ES [10,11,26,44]. In the mediation model that includes MOS Total, ES, and SDMT, social support ceases to be significant, so SDMT mediates the relationship between MOS Total and ES.…”

“…Disease-related factors, such as physical disability, fatigue, depression, and cognitive impairment, have been widely shown to be associated with work difficulties and unemployment [10,11]. However, it is also important to consider less-studied environmentalcontextual variables and their interaction with disease-related factors [12,13].…”

The relationship between cognition, education, and employment in multiple sclerosis patients

“… 30 A recent cross-sectional study of 260 MS patients found that in addition to physical disability and cognitive impairment, female sex was a strong predictor of unemployment while years of education were protective. 31 …”

Assessment of Psychopathological Changes and Mental Functioning in Patients with Multiple Sclerosis – a Literature Review

“…First of all, progressive disability means that they are no longer able to perform their previous work [33]. Multiple sclerosis is the most common cause of non-traumatic, chronic neurological disability affecting young adults during their key years of employment [34]. Regardless of gender and age, people with MS are afraid of losing their jobs.…”