Predictors of unemployment status in people with relapsing multiple sclerosis: a single center experience

Background Multiple sclerosis (MS) is the most common cause of nontraumatic chronic neurological disability affecting young adults during their crucial employment years. Objectives To evaluate patients and disease related factors associated to unemployment in a cohort of relapsing-remitting (RR) MS patients. Methods We included RRMS patients with a follow-up of at least 1 year. We collected data about years of school education and employment status. Patients underwent a neuropsychological evaluation using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Demographic and clinical predictors of unemployment were assessed through a multivariable stepwise logistic regression model. Results We evaluated 260 consecutive RRMS patients. Employed patients were less frequently female (68.4% vs 83.3%, p = 0.006), less disabled (median Expanded Disability Status Scale (EDSS) score: 2.0 (0-7.0) vs 2.5 (0-7.5), p < 0.001), with more years of school education (mean +/- standard deviation (SD), years: 13.74 +/- 0.30 vs 10.86 +/- 3.47, p < 0.001). Female sex and a higher EDSS score resulted associated with a greater risk of unemployment (OR 3.510, 95% CI 1.654-7.448, p = 0.001; OR 1.366, 95% CI 1.074-1.737, p = 0.011, respectively), whereas a greater number of years of schooling and current disease-modifying therapy exposure resulted protective factors (OR 0.788, 95% CI 0.723-0.858, p < 0,001; OR 0.414, 95% CI 0.217-0.790, p = 0.008, respectively). Conclusions Understanding work is pervasively influenced by consequences of MS, we confirmed the impact of demographic, physical, and cognitive factors on employment status in RRMS patients.

Automated summary

This study evaluated factors associated with unemployment in patients with relapsing-remitting multiple sclerosis (RRMS). The results showed that female gender, more severe disease disability, and lower education level were associated with a higher risk of unemployment. On the other hand, receiving treatment and having a longer education period were protective factors against unemployment.