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Observational Study
. 2019 Dec;40(12):2555-2564.
doi: 10.1007/s10072-019-03999-w. Epub 2019 Jul 19.

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

Dennis A M van Gorp  1   2   3   4 , Karin van der Hiele  5   6   7 , Marco A P Heerings  5 , Peter J Jongen  8   9 , Jac J L van der Klink  10 , Michiel F Reneman  11 , Edo P J Arnoldus  7 , Ernesto A C Beenakker  12 , Jeroen J J van Eijk  13 , Stephan T F M Frequin  14 , Koen de Gans  15 , Elske Hoitsma  16 , Jop P Mostert  17 , Wim I M Verhagen  18 , Désirée Zemel  19 , Leo H Visser  7   20 , Huub A M Middelkoop  6   21
Affiliations
Observational Study

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

Dennis A M van Gorp et al. Neurol Sci. 2019 Dec.

Abstract

Background: Cognitive functioning has been linked to employment outcomes in multiple sclerosis (MS) in cross-sectional studies. Longitudinal studies are however lacking and previous studies did not extensively examine executive functioning.

Objectives: We examined whether baseline cognitive functioning predicts a change in employment status after 2 years, while taking into account mood, fatigue and disability level.

Methods: A total of 124 patients with relapsing-remitting MS (pwMS) and 60 healthy controls were included. They underwent neurological and neuropsychological examinations and completed online questionnaires. PwMS were divided into a stable and deteriorated employment status group (SES and DES), based on employment status 2 years after baseline. We first examined baseline differences between the SES and DES groups in cognitive functioning, mood, fatigue and disability level. A logistic regression analysis was performed, with change in employment status (SES/DES) as dependent variable.

Results: The DES group included 22% pwMS. Group differences were found in complex attention, executive functioning, self-reported cognitive functioning, fatigue and physical disability. More physical disability (OR = 1.90, p = 0.01) and lower executive functioning (OR = 0.30, p = 0.03) were retained as independent predictors of DES (R2 = 0.22, p ≤ 0.001).

Conclusions: Baseline physical disability and executive functioning, but none of the other variables, moderately predicted a deterioration in employment status 2 years later.

Trial registration: This observational study is registered under NL43098.008.12: 'Voorspellers van arbeidsparticipatie bij mensen met relapsing-remitting Multiple Sclerose'. This study is registered at the Dutch CCMO register (https://www.toetsingonline.nl).

Keywords: Cognition; Employment; Executive function; Multiple sclerosis; Physically disabled; Work.

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Conflict of interest statement

MH, HM, JvdK, MR, EB and KdG have nothing to disclose. DvG received honoraria for presentation from Sanofi Genzyme. KvdH received honoraria for consultancies, presentations and advisory boards from Sanofi Genzyme and Merck. PJ received honoraria from Bayer, Merck and Teva for contributions to symposia as a speaker or for educational or consultancy activities. EA received honoraria for lectures and honoraria for advisory boards from Teva, Merck, Sanofi Genzyme, Biogen and Novartis. JvE received honoraria for lectures and honoraria for advisory boards from Teva, Merck, Sanofi Genzyme, Biogen, Roche and Novartis. SF received honoraria for lectures, grants for research and advisory boards from Teva, Merck, Sanofi Genzyme, Biogen, Novartis and Roche. EH received honoraria for lectures, travel grants and honoraria for advisory boards from Novartis, Teva, Roche, Merck, Sanofi Genzyme, Biogen and Bayer. JM received personal fees from Novartis, Merck, Sanofi Genzyme and Teva. WV received honoraria for lectures from Biogen and Merck, reimbursement for hospitality from Biogen, Teva, Sanofi Genzyme and Merck, and honoraria for advisory boards from Merck. DZ received honoraria for advisory boards from Novartis, Merck, Sanofi Genzyme and Biogen. LV received honoraria for lectures, grants for research and honoraria for advisory boards from Sanofi Genzyme, Merck, Novartis and Teva.

Figures

Fig. 1
Fig. 1
Flow chart of the inclusion of patients with MS
See this image and copyright information in PMC

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