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

Dennis A.M. Van Gorp*, Karin Van Der Hiele, Marco A.P. Heerings, Peter J. Jongen, Jac J.L. Van Der Klink, Michiel F. Reneman, Edo P.J. Arnoldus, Ernesto A.C. Beenakker, Jeroen J.J. Van Eijk, Stephan T.F.M. Frequin, Koen De Gans, Elske Hoitsma, Jop P. Mostert, Wim I.M. Verhagen, Désirée Zemel, Leo H. Visser, Huub A.M. Middelkoop

*Corresponding author for this work

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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.
Original languageEnglish
Pages (from-to)2555-2564
JournalNeurological Sciences
Volume40
Issue number12
DOIs
Publication statusPublished - 2019

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Keywords

  • ANXIETY
  • Cognition
  • DEPRESSION
  • DIFFICULTIES
  • DISORDERS
  • Employment
  • Executive function
  • FATIGUE
  • IMPAIRMENT
  • MINIMAL ASSESSMENT
  • Multiple sclerosis
  • PERFORMANCE
  • Physically disabled
  • VALIDITY
  • WORK
  • Work

Cite this

Van Gorp, D. A. M., Van Der Hiele, K., Heerings, M. A. P., Jongen, P. J., Van Der Klink, J. J. L., Reneman, M. F., ... Middelkoop, H. A. M. (2019). Cognitive functioning as a predictor of employment status in relapsing-remitting multiple sclerosis: A 2-year longitudinal study. Neurological Sciences, 40(12), 2555-2564. https://doi.org/10.1007/s10072-019-03999-w