Cognitive functioning as a predictor of employment status in relapsing-remitting multiple sclerosis: a 2-year longitudinal study

Gorp, D. A. M. van; Hiele, Karin van der; Heerings, Marco; Jongen, Peter Joseph; Klink, Jac J. L. van der; Reneman, Michiel F.; Arnoldus, E. P. J.; Beenakker, E. A. C.; Eijk, J.J.J. van; Frequin, S.T.F.M.; Gans, Koen de; Hoitsma, Elske; Mostert, Jop; Verhagen, W. I. M.; Zemel, Désirée; Visser, Leo H.; Middelkoop, Huub A. M.

doi:10.1007/s10072-019-03999-w

Cited by 24 publications

(17 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…25 We showed that every unit increase in EDSS at 5 years was associated with a 35%-95% increased risk of being in an early-deteriorated employment and/or workhours trajectory. This is supported by some 13,14 but not all studies. 11,12 We also found that every additional relapse during the first 5 years post-FCD was associated with a 10% increased risk of being in the reduced part-time compared to increased part-time workhours trajectory.…”

Section: Discussionmentioning

confidence: 66%

See 1 more Smart Citation

Long-term trajectories of employment status, workhours and disability support pension status, after a first episode of CNS demyelination

et al. 2022

View full text Add to dashboard Cite

Background: People with multiple sclerosis face significant employment-related challenges, with little known of the drivers of these outcomes. Objective: We examined prospective trajectories of employment-related outcomes up to 11 years following a first episode of central nervous system (CNS) demyelination (FCD). Methods: Participants were aged 18–59 years, at FCD, with at least two observations and were employed at study entry or anytime during follow-up ( n = 207). Outcomes were employment status (full-time, part-time and unemployed), average workhours per week and disability support pension (DSP; receiving/not receiving). We used group-based trajectory modelling to identify groups with common trajectories. Factors associated with trajectory membership were explored using log-multinomial regression. Results: Distinct trajectories were identified for employment (4), workhours (4) and DSP (2). Compared with stable full-time, female sex was strongly associated with being in the stable part-time trajectory (risk ratio (RR): 5.35; 95% confidence interval (CI) = 2.56–11.20; p < 0.001). A greater level of disability at 5-year review (RR: 1.35; 95% CI = 1.19–1.53) and having more than two comorbidities at baseline (RR: 2.77; 95% CI = 1.37–5.64) were associated with being in early and late deteriorated employment trajectories, respectively. Compared with the increased part-time trajectory, every additional relapse during the 5 years post-FCD was associated with a 10% increased risk of being in the reduced part-time trajectory (RR = 1.10; 95%CI = 1.00–1.22). For every additional EDSS point at 5-year review, the risk of being in the DSP trajectory increased (RR = 1.21; 95% CI = 1.05–1.41). Conclusion: These trajectories indicate substantial heterogeneity and the complex impact of MS on employment from its earliest timepoints. Understanding these trends could enable better targeting of interventions to facilitate workforce retention, particularly for females, those with a higher number of comorbidities, more frequent relapses and greater rate of disability accrual.

show abstract

Section: Discussionmentioning

confidence: 66%

“…9,10 Moreover, evidence from longitudinal studies demonstrates that status of these demographic/clinical factors at baseline can be predictive of short-and long-term outcomes. [11][12][13][14] Therefore, examining the impact of potential determinants of employment outcomes from the early stages of illness is of importance for PwMS.…”

Section: Introductionmentioning

confidence: 99%

Long-term trajectories of employment status, workhours and disability support pension status, after a first episode of CNS demyelination

et al. 2022

View full text Add to dashboard Cite

show abstract

“…One study found that indirect costs, unlike total and drug costs, were not predicted by fatigue [ 77 ]. Six studies found an association between fatigue and employment status [ 67 , 69 , 74 , 80 , 82 , 86 ]; conversely, five studies failed to find a statistically significant association [ 66 , 68 , 76 , 79 , 83 ].…”

Section: Resultsmentioning

confidence: 99%

Prevalence and burden of multiple sclerosis-related fatigue: a systematic literature review

et al. 2021

View full text Add to dashboard Cite

Background Multiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system that results in progressive and irreversible disability. Fatigue is one of the most common MS-related symptoms and is characterized by a persistent lack of energy that impairs daily functioning. The burden of MS-related fatigue is complex and multidimensional, and to our knowledge, no systematic literature review has been conducted on this subject. The purpose of this study was to conduct a systematic literature review on the epidemiology and burden of fatigue in people with multiple sclerosis (pwMS). Methods Systematic searches were conducted in MEDLINE, Embase, and Evidence-Based Medicine Reviews to identify relevant studies of fatigue in pwMS. English-language records published from 2010 to January 2020 that met predefined eligibility criteria were included. We initially selected studies that reported quality of life (QoL) and economic outcomes according to categories of fatigue (e.g., fatigued vs non-fatigued). Studies assessing associations between economic outcomes and fatigue as a continuous measure were later included to supplement the available data. Results The search identified 8147 unique records, 54 of which met the inclusion criteria. Of these, 39 reported epidemiological outcomes, 11 reported QoL, and 9 reported economic outcomes. The supplementary screen for economic studies with fatigue as a continuous measure included an additional 20 records. Fatigue prevalence in pwMS ranged from 36.5 to 78.0%. MS-related fatigue was consistently associated with significantly lower QoL. Results on the economic impact of fatigue were heterogeneous, but most studies reported a significant association between presence or severity of fatigue and employment status, capacity to work, and sick leave. There was a gap in evidence regarding the direct costs of MS-related fatigue and the burden experienced by caregivers of pwMS. Conclusion Fatigue is a prevalent symptom in pwMS and is associated with considerable QoL and economic burden. There are gaps in the evidence related to the direct costs of MS-related fatigue and the burden of fatigue on caregivers. Addressing fatigue over the clinical course of the disease may improve health and economic outcomes for patients with MS.

show abstract

“…Cognitive functioning has been closely linked to employment status in MS patients. For instance, a prospective study of 124 relapsing–remitting patients over 2 years found that baseline executive functioning and physical disability were significant predictors of deteriorated employment status, 25 which was defined as loss of employment or a 20% decrease in work hours because of MS. Baseline physical and executive functioning were significant predictors of a negative employment outcome. A cross-sectional retrospective study of 158 persons with MS had similar findings, with an expanded disability status scale, 26 SDMT, and the Hospital Anxiety and Depression Scale 27 as significant predictors of vocational status.…”

Section: Discussionmentioning

confidence: 99%

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

Conway

Bermel

Planchon

2022

Multiple Sclerosis Journal - Experimental, Translational and Cl

View full text Add to dashboard Cite

Background Processing speed decline is a common manifestation of multiple sclerosis (MS). The processing speed test (PST) is a validated electronic cognitive assessment based on the Symbol–Digit Modalities Test, which is routinely administered as part of the multi-institutional Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS) initiative. The longitudinal relationship between education, processing speed, and employment is unclear. Objectives Determine the longitudinal impact of educational attainment on processing speed and employment. Methods MS PATHS data through March 2020 were analyzed. Repeat PST assessments at 1, 2, and 3 years were classified as improved, worsened, or stable. Linear regression was used to evaluate the relationship between education and baseline PST performance and logistic regression was used to determine the odds of PST worsening by educational attainment. Employment outcomes were analyzed by PST status and educational level. Results There were 13,732 patients analyzed. Education impacted baseline PST scores, but had a limited effect on PST performance over time. Education was protective with respect to employment in the setting of both PST worsening and improvement. Conclusion Greater education results in better baseline processing speed and is protective with respect to employment status. Its impact on processing speed over time is marginal.

show abstract

Cognitive functioning as a predictor of employment status in relapsing-remitting multiple sclerosis: a 2-year longitudinal study

Cited by 24 publications

References 39 publications

Long-term trajectories of employment status, workhours and disability support pension status, after a first episode of CNS demyelination

Long-term trajectories of employment status, workhours and disability support pension status, after a first episode of CNS demyelination

Prevalence and burden of multiple sclerosis-related fatigue: a systematic literature review

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

Contact Info

Product

Resources

About