Identifying key determinants of work-related difficulties in multiple sclerosis: integrating clinical measures and...

One of the most social consequences of Multiple Sclerosis (MS) is a reduction in employability that occurs early in the disease. The aim of the study is to explore the factors contributing to specific work-related difficulties, including main functions affected by MS.

The study involved two Italian centers and included subjects with MS diagnosis of working age (18-65 years) and currently employed. Subjects underwent an evaluation to investigate work-related difficulties, socio-occupational data and the main clinical domain affected by MS with an impact on work-related difficulties, such as walking, balance, upper limb and cognitive functions, mood and fatigue. Linear regression analysis was used to examine the direction and size of the relationships between specific work-related difficulty and the variables examined.

A total of 82 subjects with MS were recruited (59.8% of females, mean age 44.0 (SD: 10.7) years, a mean EDSS score of 3.7 (SD: 2.4); mean education of 15.2 (SD: 4.2) years). The 36.6% of the sample resulted having work-related difficulties with a possible consequent risk of job lost. Our results highlighted that objective assessment of walking and balance, upper limb and cognitive functions were not significant determinants of any specific work-related difficulties. However, the key factors most strongly associated with work challenges are the presence of depressive symptoms, followed by physical and cognitive fatigue.

Identifying the main factors related to work difficulties is a fundamental step to prevent the manifestation of these difficulties and develop tailored intervention for job retention.