Factors That Affect Working Ability in Patients with MS Besides Physical Disability

Aside from physical impairment, a study found that cognitive functions, neuropsychiatric symptoms including depressive episodes and fatigue, and clinical data including disease duration and comorbidities may also be significant factors to consider when evaluating working ability in patients with multiple sclerosis (MS).

Patients with MS were stratified into two groups: relapsing disease course (RMS; n=84) and progressive disease course (PMS; n=75). Both cohorts were assessed using the Brief International Cognitive Assessment for MS battery and mood and fatigue questionnaires and also underwent screening for subjectively experienced cognitive problems and patient- and disease-related information. Expanded Disability Status Scale (EDSS) scores were also calculated. Results were compared among unemployed and part- and full-time working patients.

Unemployed patients with RMS had a higher level of fatigue and EDSS scores, more comorbidities and frequent past depressive episodes, and a poorer performance on the Symbol Digit Modalities Test (SDMT) and the Brief Visuospatial Memory Test revised (BVMT-R). Predictors of unemployment were EDSS and SDMT; number of comorbidities, BVMT-R, and disease duration forecasted weekly hours at work.

Unemployed patients with PMS had higher EDSS scores, younger age, and poorer performance in SDMT and the Rey Verbal Learning and Memory Test German version (Verbaler Lern- und Merkfaehigkeitstest; VLMT). VLMT, education level, disease duration, and EDSS were predictive of employment status and weekly working hours; depressive episodes also affected employment status.