Employment in multiple sclerosis. Exiting and re-entering the work force

Area of Science:

• Neurology
• Occupational Health
• Rehabilitation Science

Background:

• Multiple sclerosis (MS) presents substantial economic challenges, notably high unemployment rates among patients.
• Understanding factors influencing employment status is crucial for patient support and economic stability.

Purpose of the Study:

• To identify patient and disease characteristics associated with work loss and work initiation in individuals with MS.
• To evaluate these factors cross-sectionally and prospectively.

Main Methods:

• Utilized the NARCOMS patient registry for data collection.
• Analyzed data from 8,867 patients cross-sectionally and 8,122 patients longitudinally over approximately 1.56 years.
• Assessed patient and disease characteristics, disability levels (PDDS), and functional performance scales.

Main Results:

• Over 56% of MS patients remained unemployed at both assessment periods.
• At baseline, unemployment was linked to progressive MS, longer symptom duration, higher disability, and broader functional limitations.
• Worsening MS symptoms, mobility issues, hand function deficits, fatigue, and cognitive problems predicted unemployment. Milder deficits in these areas predicted re-employment.

Conclusions:

• MS is strongly associated with high unemployment rates.
• Specific physical and cognitive functional limitations are key predictors of both employment cessation and initiation.
• Findings support targeted rehabilitation interventions to address MS-related limitations and improve employment outcomes.