Sustained Attention and Working Memory Predict the Number of Days on Health-Related Benefits in the Year Following Occupational Rehabilitation

Abstract

Purpose The objective of this study was to investigate the association between cognitive and emotional functioning and the number of days on health-related benefits such as sick leave, work assessment allowance and disability pension. We investigated whether cognitive and emotional functioning at the start of rehabilitation and the change from the start to the end of rehabilitation predicted the number of days on health-related benefits in the year after occupational rehabilitation. Methods A sample of 317 individuals (age 19–67 years), mainly diagnosed with a musculoskeletal or mental and behavioural ICD-10 disorder, participated. The sample was stratified depending on the benefit status in the year before rehabilitation. Those receiving health-related benefits for the full year comprised the work assessment allowance and disability pension (WAA) group and those receiving benefits for less than a year comprised the sick leave (SL) group. The participants were administered cognitive and emotional computerised tests and work and health questionnaires at the beginning and end of rehabilitation. The cumulative number of days on health-related benefits during 12 months after rehabilitation was the primary outcome variable and age, gender, educational level, subjective health complaints, anxiety, and depression were controlled for in multiple regression analyses. Results The WAA group (n = 179) was significantly impaired at baseline compared to the SL group (n = 135) in focused attention and executive function, and they also scored worse on work and health related variables. Higher baseline scores and change scores from the start to the end of rehabilitation, for sustained attention, were associated with fewer number of health-related benefit days in the WAA group, while higher baseline scores for working memory were associated with fewer number of health-related benefit days in the SL group. Conclusions New knowledge about attention and memory and return to work in individuals with different benefit status may pave the way for more targeted programme interventions. Rehabilitation programmes could benefit from designing interventions that respectively improve sustain attention and working memory related to working life in individuals on sick leave or work assessment allowance and disability pension.

Neuropsychological predictors of vocational rehabilitation outcomes in individuals with major depression: A scoping review

“…The significant results regarding cognitive predictors of rehabilitation success suggest that even with individual vocational and psychosocial services, higher baseline cognitive functioning predicts better work-related outcomes. This is in line with studies showing that improvement in cognitive functioning can contribute to more positive outcomes of rehabilitation interventions ( 70 , 71 ). Furthermore, cognitive remediation has the potential to improve work outcomes of rehabilitation interventions ( 38 ).…”

Cognitive flexibility is associated with sickness resilience

“…Although our results are novel for the normally working population they are in line with several studies on patients. For example, it has been shown that EF may predict absence from work following in-patient occupational rehabilitation ( Johansen et al, 2021 ) as well as for individuals with ADHD ( Biederman et al, 2006 ; Halleland et al, 2019 ). Another study compared remitted bipolar patients that were able to continue to be active (studying or working) with those who were inactive (e.g., unemployed, received early retirement benefit or being on long term sick leave; Drakopoulos et al, 2020 ).…”

Changes in memory and attention during and after occupational rehabilitation: A longitudinal study

“…The rehabilitation sample was divided into three sick leave groups based on how much each individual was on sick leave in the year after rehabilitation: 100-75%, 74-40% and 39-0%. The individuals belonging to these categories and a control group were compared in order to investigate whether there were differences in improvements in sustained attention and working memory both during and after rehabilitation, thus extending previous findings [9,10,16]. It was hypothesised that the degree of work participation is relevant to recovery of cognitive functioning in sick-listed individuals after occupational rehabilitation, where higher work participation would result in larger improvement in sustained attention and working memory.…”

“…The focus of this study is to explore the degree to which the amount of time spent at work positively influences memory and attention. These two domains were selected because it has been shown that attention and memory functions improve more than executive function and emotion regulation in occupational rehabilitation patients [9,10] as well as being associated with RTW [16]. Sustained attention and working memory were specifically selected as the cognitive constructs in the current study.…”

“…Working memory is a limited and short-term capacity store for holding information and for engaging the information of this store [18]. Improvements in sustained attention and higher scores in working memory are also associated with reduced sick leave rates in the year following rehabilitation [16]. The opposite has also been documented, that impairments in working memory is associated with a higher chance of being unemployed or full-time sickness absent [14].…”