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. 2019 Apr;25(5):740-749.
doi: 10.1177/1352458518769837. Epub 2018 Apr 17.

The effect of self-assessed fatigue and subjective cognitive impairment on work capacity: The case of multiple sclerosis

Gisela Kobelt  1 , Dawn Langdon  2 , Linus Jönsson  3
Affiliations

The effect of self-assessed fatigue and subjective cognitive impairment on work capacity: The case of multiple sclerosis

Gisela Kobelt et al. Mult Scler. 2019 Apr.

Abstract

Objectives: The impact of physical disability in multiple sclerosis on employment is well documented but the effect of neurological symptoms has been less well studied. We investigated the independent effect of self-reported fatigue and cognitive difficulties on work.

Methods: In a large European cost of illness survey, self-reported fatigue, subjective cognitive impairment (SCI), and productivity at work were assessed with visual analogue scales (VAS 0-10). The analysis controlled for country, age, age at diagnosis, gender, education, and physical disability.

Results: A total of 13,796 patients were of working age and 6,598 were working. Physical disability had a powerful impact on the probability of working, as did education. The probability of working was reduced by 8.7% and 4.4% for each point increase on the VAS for SCI and fatigue, respectively ( p < 0.0001). Regular work hours decreased linearly with increasing severity of fatigue and cognitive problems, while sick leave during the 3 months preceding the assessment increased. Finally, the severity of both symptoms was associated with the level at which productivity at work was affected ( p < 0.0001).

Conclusion: Our results confirm the independent contribution of self-reported fatigue and SCI on work capacity and highlight the importance of assessment in clinical practice.

Keywords: Multiple sclerosis; cognitive deficits; fatigue; work capacity.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: G.K. has provided consulting and speaking services to from Almirall, Bayer, Biogen, Merck Serono, Novartis, Oxford PharmaGenesis, Roche, Sanofi Genzyme, and Teva. D.L. has participated in speaker bureaus for Bayer, Merck, Almirall, Execemed, Teva, Roche, Novartis, Biogen, and Sanofi; has consulted with Novartis, Bayer, Merck, Biogen, Teva, and Sanofi; has had research grants from Bayer, Merck, Novartis, and Biogen. All fees are paid into her institution. L.J. is employed by H. Lundbeck and has provided consulting and advisory services to Ipsen, Pfizer, Merck, Sanofi, and Biogen.

Figures

Figure 1.
Figure 1.
Hours worked per week in relation to self-reported cognitive function and fatigue: The average number of hours worked per week in relation to the severity of cognitive symptoms (line in left pane) and fatigue (line in right pane), respectively. Bars represent the share of the sample within each category of symptom severity. Cognitive symptoms and fatigue were self-assessed on a visual analogue scale where 0 indicates no symptoms and 10 severe symptoms. The analyses controlled for country, gender, age, disease duration, educational level, and physical disability (EDSS score).
Figure 2.
Figure 2.
Sick leave days and degree work affected in relation to cognitive difficulties and fatigue: The average number of days of sick leave in the past 3 months, and the effect of MS on the ability to complete work tasks, in relation to subjective cognitive problems (left pane) and fatigue (right pane). Cognitive symptoms, fatigue, and the impact on productivity while at work were self-assessed on visual analogue scales, where 0 indicates no symptoms/impact and 10 severe symptoms/impact. The analyses controlled for country, gender, age, disease duration, educational level, and physical disability (EDSS score).
See this image and copyright information in PMC

References

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