Pediatric-onset MS Tied to Fewer School Years, Lower Income in Adulthood

People who develop multiple sclerosis (MS) as children are more likely to attain lower education levels, earn less in the workplace, and be more reliant on disability benefits later in life, new research shows.

These findings were published in JAMA Neurology, in the study, “Long-term Socioeconomic Outcomes Associated With Pediatric-Onset Multiple Sclerosis.”

Up to 10% of people with MS experience their first symptoms in childhood and are diagnosed with pediatric-onset MS (PoMS). Compared to people who develop MS later in life, pediatric patients live with the disease throughout their entire adult life. This is likely to impact life in a variety of ways, and understanding the obstacles faced by PoMS patients can inform better care and support strategies.

A team of Swedish researchers assessed the impact of PoMS on educational attainment, income, and the use of disability benefits as working-age adults.

Using Swedish national databases, the scientists identified relevant data for 485 people with PoMS, diagnosed from 1980 to 2014. For comparison, they identified 4,850 people without MS (a control group), who were matched in terms of sex, age, and other demographic factors. In both groups, the average age was 32, and 71.8% of both groups were women.

No differences were seen between the two groups in terms of high school attendance. However, PoMS patients were 20% less likely than controls to attend university.

Earnings and use of disability benefits were then investigated across four age groups: 19–24 years, 25–34 years, 35–44 years, and 45–54 years.

Compared with controls, people with PoMS had significantly less income on average across all four age groups. The gap rose with increasing age: among 19- to 24-year-olds, PoMS patients made on average $1,618 less per year than those without MS; among 45- to 54-year-olds, the difference was $10,683 each year.

Across all age groups, people with PoMS were also more likely to have zero earnings. Of note, analyses that only included people with positive earnings still showed PoMS patients making significantly less.

The researchers also noted that earning patterns differed between the two groups. “Earnings plateaued in early adulthood among individuals with PoMS, whereas they continued to increase among individuals in the matched reference cohort,” they wrote.

These differences, they speculated, could reflect that people with PoMS have a harder time finding or remaining in paid work.

People with PoMS were more likely than those without MS to miss work due to sickness, and were more likely to receive at least one disability pension day.

Rates of disability use were significantly higher among PoMS patients for the oldest two age groups (35–44 years and 45–54 years), but not among the two younger groups (19–24 years and 25–34 years).  According to the researchers, this suggests “that patients who received a diagnosis more recently may be performing better, perhaps owing to improved treatment strategies.”

Analyses that differentiated between MS which began in adolescence or earlier in childhood found largely consistent results.

“We found that PoMS has profound, lasting consequences that translate into lower educational achievements and earnings and a greater use of disability benefits in adulthood,” the researchers concluded.

“Assessing whether specific clinical or demographic factors are associated with these socioeconomic outcomes will be the next step in understanding, and potentially preventing, these outcomes,” they added.

The researchers noted that this study has some limitations — most notably that, because analyzed data all came from Swedish databases, the applicability of its findings outside of Sweden is unclear.