Unemployment in multiple sclerosis (MS): utility of the MS Functional Composite and cognitive testing

Abstract

Unemployment is a significant concern among individuals with multiple sclerosis (MS). Determinations regarding ability to work are highly dependent on measurement tools used by neurologists and allied professionals. However, little is known of the usefulness of these tools when determining issues pertaining to employment status. The purpose of the present investigation was to examine the utility of the Multiple Sclerosis Functional Composite (MSFC) and a brief cognitive test battery when examining employment status in MS. Seventy-seven individuals with MS completed the MSFC and a brief cognitive test battery. On the MSFC, unemployed individuals demonstrated worse upper extremity functioning. There was no difference on the Paced Auditory Serial Addition Task (PASAT), the sole cognitive measure of the MSFC. On cognitive testing, unemployed individuals performed worse on measures of memory, information processing speed, and executive functioning. Through logistic regression analysis, the Symbol Digit Modalities Test (SDMT) was found to be the sole predictor of employment status among the significant disease, MSFC and cognitive variables. Consistent with previous findings, logistic regression found the SDMT to be a significant predictor of employment status. Given the lack of significant group differences on the PASAT, continued consideration of replacing the PASAT with the SDMT in the MSFC appears warranted.

Keywords

Multiple sclerosis employment disability

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References

Kornblith

LaRocca

Baum

. Employment in individuals with multiple sclerosis. Int J Rehabil Res 1986; 9: 155–165.

Kurtzke

. Rating neurologic impairment in multiple sclerosis: An Expanded Disability Status Scale (EDSS). Neurology 1983; 33: 1444–1452.

Rudick

Polman

Cohen

. Assessing disability progression with the multiple sclerosis functional composite. Mult Scler 2009; 15: 984–997.

Fisher

Rudick

Cutter

. Multiple Sclerosis Functional Composite (MSFC): An integrated approach to MS clinical outcome assessment. National MS Society Clinical Outcomes Assessment Task Forice. Mult Scler 1999; 5: 244–250.

Honarmand

Akbar

Kou

. Predicting employment status in multiple sclerosis patients: The utility of the MS functional composite. J Neurol 2011; 258: 244–249.

Pompeii

Moon

McCrory

. Measures of physical and cognitive function and work status among individuals with multiple sclerosis: A review of the literature. J Occup Rehabil 2005; 15: 69–84.

Benedict

Cookfair

Gavett

. Validity of the minimal assessment of cognitive function in multiple sclerosis (MACFIMS). J Int Neuropsychol Soc 2006; 12: 549–558.

Strober

Christodoulou

Benedict

. Unemployment in multiple sclerosis: The contribution of personality and disease. Mult Scler 2012; 18: 647–653.

Morrow

Drake

Zivadinov

. Predicting loss of employment over three years in multiple sclerosis: Clinically meaningful cognitive decline. Clin Neuropsychol 2010; 7: 1–15.

10.

Drake

Weinstock-Guttman

Morrow

. Psychometric and normative data for the Multiple Sclerosis Functional Composite: Replacing the PASAT with the symbol digit modalities test. Mult Scler 2010; 16: 228–237.