North America and Europe clarified links between cognitive, psychological, and physical disability factors and risk for job loss of people with multiple sclerosis (PwMS), that are not well understood in a spanish-speaking South American countries with higher poverty and unemployment rates.
Objectives
Replicate the prevalence of Employment Status (ES) in PwMS from the previous study in Argentina and analyze the differences between ES groups -work-stable, work-challenged or work-loss- in demographic, clinical and cognitive variables. To compare ES between PwMS and healthy controls (HCs) and to identify work challenges, job types, disability assistance, and work-place accommodations among patients in Argentina.
Methods
80 PwMS and 80 HCs were enrolled in a case-control design. All participants were examined with the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and Buffalo Vocational Monitoring Survey (BVMS), to explore ES and negative work events (NWEs), work-accommodations, work hours and job types.
Results
PwMS showed worse ES than HCs (PwMS vs. HCs): work-challenged 51.2% vs. 90%, work-challenged 25% vs. 6.2% & work-loss 23.8% vs. 3.8%. In PwMS there were significant differences in SDMT scores between the work-stable and both the work- challenged (p < 0.01) and the work-loss group (p < 0.01). Also work-stable and work- challenged groups had better performance on CVLT (p < 0.05), and BVMT-R (p < 0.05) compared with the work-loss group. PwMS reported more NWEs and accommodations than HCs. Similar working hours and job types were found.
Conclusion
PwMS has worse vocational outcomes compared to HCs. Deficits in processing speed and physical disability may contribute to the decline in ES among PwMS.
RamosJSehnbruchKWellerJ. Quality of employment in Latin America: theory and evidence. Int Labour Rev2015; 154: 171–194.
2.
JiménezM. Job quality and its consequences for the workforce of large. Medium- sized, and public-sector companies in Argentina. Economía2017; 40: 133–180.
3.
National Institute of Statistics and Census of Argentina [Instituto Nacional de Estadística y Censos República Argentina] [Internet]. 2022. [accessed 5 February 2022]. Available from: https://www.indec.gob.ar/index.asp.
4.
VanottiSEizaguirreMBCiufiaNP, et al.Employment status monitoring in an argentinian population of patients with multiple sclerosis: particularities of a developing country. Work2021; 68: 1121–1131.
5.
Carnero ContenttiEPettinicchiJPLopezPA, et al.Access and unmet needs to multiple sclerosis care in a cohort of Argentinean patients. Mult Scler Relat Disord2019; 33: 88–93.
6.
Carnero ContenttiEGiachelloSCorrealeJ. Barriers to access and utilization of multiple sclerosis care services in a large cohort of Latin American patients. Multiple Sclerosis J2021; 27: 117–129.
7.
VitturiBKRahmaniADiniG, et al.Stigma, discrimination and disclosure of the diagnosis of multiple sclerosis in the workplace: a systematic review. Int J Environ Res Public Health2022; 19: 9452.
8.
SalterAThomasNTyryT, et al.Employment and absenteeism in working- age persons with multiple sclerosis. J Med Econ2017; 20: 493–502.
9.
GuerraTPipoliAViterboRG, et al.Predictors of unemployment status in people with relapsing multiple sclerosis: a single center experience. Neurol Sci2022; 43: 4387–4392.
10.
van GorpDAMvan der HieleKHeeringsMAP, et al.Cognitive functioning as a predictor of employment status in relapsing-remitting multiple sclerosis: a 2-year longitudinal study. Neurol Sci2019; 40: 2555–2564.
11.
BeierMHartoonianND'OrioVL, et al.Relationship of perceived stress and employment status in individuals with multiple sclerosis. Work2019; 62: 243–249. PMID: 30829635.
12.
RománMSGonzálezFMBardoneschiL, et al.Contextual factors matter: the role of social support in work-related difficulties and employment Status in persons with multiple sclerosis. Sclerosis2024; 2: 65–76.
13.
KalbRBeierMBenedictRH, et al.Recommendations for cognitive screening and management in multiple sclerosis care. Mult Scler2018; 24: 1665–1680.
14.
Jaworski 3rdMGFuchsTADwyerMG, et al.Conscientiousness and deterioration in employment status in multiple sclerosis over 3 years. Multiple Sclerosis J2021; 27: 1125–1135.
15.
FrndakSEIrwinLNKordovskiVM, et al.Negative work events reported online precede job loss in multiple sclerosis. J Neurol Sci2015; 357: 209–214.
16.
BenedictRHRodgersJDEmmertN, et al.Negative work events and accommodations in employed multiple sclerosis patients. Mult Scler J2014; 20: 116–119.
17.
KordovskiVMFrndakSEFisherCS, et al.Identifying employed multiple sclerosis patients at-risk for job loss: when do negative work events pose a threat?Mult Scler Relat Disord2015; 4: 409–413.
18.
van der HieleKvan GorpDBenedictR, et al.Coping strategies in relation to negative work events and accommodations in employed multiple sclerosis patients. Mult Scler J Exp Transl Clin2016; 24: 2055217316680638.
19.
LeslieMKinyanjuiBBishopM, et al.Patterns in workplace accommodations for people with multiple sclerosis to overcome cognitive and other disease- related limitations. NeuroRehabilitation2015; 37: 425–436.
20.
ThompsonAJBanwellBLBarkhofF, et al.Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol2018; 17: 162–173.
21.
SerranoCMSorbaraMMinondA, et al.Validation of the Argentine version of the Montreal Cognitive Assessment Test (MOCA): a screening tool for mild cognitive impairment and mild dementia in elderly. Dement Neuropsychol2020; 14: 145–152.
22.
BeckATSteerRABrownGK. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation, 1996.
23.
BrenllaMERodríguezCM. Manual for the Beck Depression Inventory-II Spanish version for Argentina [Adaptación Argentina del Inventario de Depresión de ´ Beck] (BDI-II). BDI-II. The Beck Depression Inventory [Inventario de Depresión de Beck] Buenos Aires: Paidós; 2006.
24.
Argentine Society of Marketing and Opinion Researchers. Socioeconomic level in Argentina, 2015. Stratification and variables. 2015.
25.
BenedictRHAmatoMPBoringaJ, et al.Brief international cognitive assessment for MS (BICAMS): International standards for validation. BMC Neurol2012; 12: 1–7.
26.
VanottiSSmerbeckABenedictRH,et al.A new assessment tool for patients with multiple sclerosis from Spanish-speaking countries: validation of the Brief International Cognitive Assessment for MS (BICAMS) in Argentina. Clin Neuropsychol2016; 30: 1023–1031.
27.
SmithA. Symbol Digit Modalities Test (SDMT). Manual (Revised). Los Angeles: Western Psychological Services, 1982.
28.
ArtiolaIFortunyLRomoDH, et al.Manual of norms and procedures for the Neuropsychological Battery in Spanish [Manual de normas y procedimientos para la Batería en español]. 3th ed. New York: Psychology Press, 1998.
29.
DelisDCKramerJHKaplanE,et al.CaliforniaVerbal Learning Test manual. 2nd ed. San Antonio: Psychological Corporation, 2000.
30.
BenedictRH. Brief Visuospatial Memory Test - Revised: Professional manual. Odessa: Psychological Assessment Resources, Inc, 1997.
31.
MathiowetzVVollandGKashmanN,et al.Adult norms for the Box and Block Test of manual dexterity. Am J Occup Ther1985; 39: 386–391.
32.
KruppLBLaRoccaNGMuir-NashJ,et al.The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol1989; 46: 1121–1123.
33.
BenedictRHDrakeASIrwinLN, et al.Benchmarks of meaningful impairment on the MSFC and BICAMS.Mult Scler2016; 22: 1874–1882.
34.
SrpovaBSobisekLNovotnaK, et al.The clinical and paraclinical correlates of employment status in multiple sclerosis. Neurol Sci2022; 43: 1911–1920.
35.
KavaliunasATinghögPFribergE, et al.Cognitive function predicts work disability among multiple sclerosis patients. Mult Scler J Exp Transl Clin2019; 5: 2055217318822134.
36.
WalkerLAOsmanLBerardJA, et al.Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS): Canadian contribution to the international validation project. J Neurol Sci2016; 362: 147–152.
37.
MaltbyVELeaRARibbonsK, et al.Comparison of BICAMS and ARCS for assessment of cognition in multiple sclerosis and predictive value of employment status. Mult Scler Relat Disord2020; 41: 102037.
38.
Van DijkPAKirk-BrownAKTaylorB,et al.Closing the gap: longitudinal changes in employment for Australians with multiple sclerosis. Mult Scler2017; 23: 1415–1423.
39.
FuchsTAGilliesJJaworski 3rdMG, et al.Repeated forms, testing intervals, and SDMT performance in a large multiple sclerosis dataset. Mult Scler Relat Disord2022; 68: 104375.
