4.5 Review

Huntington?s disease influences employment before and during clinical manifestation: A systematic review

Journal

PARKINSONISM & RELATED DISORDERS
Volume 96, Issue -, Pages 100-108

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2022.02.022

Keywords

Employment; Working capacity; Retirement; Huntington?s disease; Genetic discrimination; Predictive testing; Review

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This systematic review summarizes the disease-specific characteristics that influence employment and working capacity in Huntington's disease (HD). The review finds that cognitive decline, motor impairments, and apathy all negatively affect employment and working capacity. Furthermore, the impact of HD extends beyond clinical manifestation, with some at-risk individuals already experiencing employment discrimination due to fear or genetic factors.
Huntington's disease (HD) is an inherited neurodegenerative disease. People at risk for HD can choose to get predictive testing years before the clinical onset. HD is characterized by motor, cognitive and psychiatric symptoms and has a mean age at onset between 30 and 50 years, an age at which people are usually still working. This systematic review focuses on summarizing which disease-specific characteristics influence employment and working capacity in HD.Twenty-three studies were identified and showed that while employment and working capacity in HD are negatively influenced by cognitive decline and motor impairments, apathy already plays a role in the prodromal stage. Moreover, the influence of HD transcends the clinical manifestation of the disease, as some people at risk are already experiencing the impact of HD on employment through fear of or actual genetic discrimination. Employment and working capacity are not influenced by predictive testing for HD in and of itself.

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