Multiple sclerosis patients of working age who are unemployed or on a reduced work schedule are likely to show considerable cognitive impairment on tests, especially those measuring mental processing speeds, than patients who are more gainfully employed, a review study reports.
This link held true even in patients with little evident physical disability, its researchers said.
The study, “How does cognition relate to employment in multiple Sclerosis? A systematic Review,” was published in the journal Multiple Sclerosis and Related Disorders.
About half of all MS patients are unemployed, a status that affects their social engagement and support. Lack of employment is also linked to depression, anxiety and feelings of loneliness, and unemployed patients report poorer health status and greater difficulties with daily life activities.
Progressive disease, longer disease duration and greater disability — as measured through the Expanded Disability Status Scale (EDSS) — plus older age, and lower levels of education associate with higher unemployment rates in MS patients.
But an exceptionally high rate — 54 percent — of MS patients in Europe are unemployed despite only mild to moderate disability evident on EDSS, with scores up to 3. (A score of 3 or less marks moderate disability in one, or mild disability in three to four, measures of bodily function like movement, swallowing, mental capacities, and bowel/bladder control. Walking is possible without any assistance, including a cane.)
Studies suggest that reasons for this might be independent of physical disability, with some showing that cognitive scores differ among healthy people who are employed, working MS patients (part- and full-time), and those who are unemployed.
Researchers at the University of London conducted a systematic literature review (via PubMed, PSYCH Info, and Web of Science) to assess a possible link between cognition and employment status in patients of working age. Studies included in their review were all peer-reviewed, involved people ages 18 to 65, and had data on standardized neuropsychological testing, and self-reported employment information.
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