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MS research update – What MS symptoms affect work? – 21 December 2015

Summary

This study looked at four key MS factors: depression, cognition, fatigue and motor function, to investigate their relationship with employment in a group of people with MS.

A group of 53 people with MS in the USA took part in the study. Each participant took part in a three to four hour long assessment session completing various tests and questionnaires to assess their cognition, motor function, mood and fatigue.

The study found that cognitive, motor function and fatigue test scores, as well as higher EDSS scores, were significantly related to unemployment.

This study shows that fatigue levels and cognitive symptoms can make it difficult for people with MS to remain in work. The researchers conclude that health professionals could support people with MS and help them learn management techniques to deal with, or compensate for, fatigue and cognitive symptoms that could help them stay employed.

Background

Unemployment can be common in people with MS, previous research has shown several symptoms, such as mobility and fatigue, can have a large impact on people and make staying in employment difficult. However support and interventions could potentially keep some people with MS in employment. This study looked at four key MS factors: depression, cognition, fatigue and motor function, to investigate their relationship with employment in a group of people with MS.

How this study was carried out

People with MS were recruited from neurologists' practices and MS newsletters in Pennsylvania, USA to take part in this study.

53 people with MS (8 men and 45 women) took part. 30 were diagnosed with relapsing remitting MS, 17 with secondary progressive MS, three with primary progressive MS, and three with progressive relapsing MS. 33 participants were employed and 20 were unemployed at the time of the study.

Each participant took part in a three to four hour long assessment session. At the start they were interviewed to collect demographic information such as age, how long they had lived with MS for and details about their employment situation. They then completed various tests and questionnaires to assess their cognition, motor function, mood and fatigue.

What was found

The study found that cognitive, motor function and fatigue test scores, as well as higher EDSS scores, were significantly related to unemployment. Levels of depression were not related to unemployment.

In particular fatigue, slowed processing speed and memory difficulties were particular problems when trying to remain in employment.

What does it mean?

This study shows that fatigue levels and cognitive symptoms can make it difficult for people with MS to remain in work. The researchers suggest that health professionals should consider these symptoms, not just physical function and mobility, when helping people remain in employment. They conclude that health professionals could support people with MS and help them learn management techniques to deal with, or compensate for, fatigue and cognitive symptoms that could help them stay employed.

Cadden M, Arnett P.
Factors associated with employment status in individuals with multiple sclerosis.
Int J MS Care. 2015 Nov-Dec;17(6):284-91.
Abstract
Read the full text of this paper 

More about work and MS

MS is different for everyone. The different symptoms someone may experience at different times and the impact of the symptoms on working life will very much depend on the type of work, and personal experience of MS.

The rights of people with multiple sclerosis in the workplace and when looking for employment are covered by the Equality Act. This protects people with MS from any form of discrimination from the point of diagnosis. One of the key provisions of the Act is that employers are expected to consider making 'reasonable adjustments' for employees with MS. There is no precise definition for what constitutes a 'reasonable adjustment' but examples might include changing working hours. Additionally the Access to Work scheme from the government provides grants that can pay for practical support if you have a disability, health or mental health condition to help pay for things that might help you start working or stay in work.

You can read more about work and MS in our At work with MS information online

You can also read more about managing fatigue in Living with Fatigue  and manging cognitive symptoms in StayingSmart

Research by topic areas...

Assessment tools

Kirkland MC, Wallack EM, Rancourt SN, et al.
Comparing three dual-task methods and the relationship to physical and cognitive impairment in people with multiple sclerosis and controls.
Mult Scler Int. 2015;2015:650645.
Abstract
Read the full text of this paper

Lamargue-Hamel D, Deloire M, Saubusse A, et al.
Cognitive evaluation by tasks in a virtual reality environment in multiple sclerosis.
J Neurol Sci. 2015 Dec 15;359(1-2):94-9.
Abstract

Carers

McKenzie T, Quig ME, Tyry T, et al.
Care partners and multiple sclerosis: differential effect on men and women.
Int J MS Care. 2015 Nov-Dec;17(6):253-60.
Abstract
Read the full text of this paper

Co-existing conditions

Kaplan TB, Berkowitz AL, Samuels MA.
Cardiovascular dysfunction in multiple sclerosis.
Neurologist. 2015 Dec;20(6):108-14.
Abstract

Conference

Sastre-Garriga J, Wiendl H.
Highlights from the 31st ECTRIMS congress - Barcelona 2015.
Mult Scler. 2016 Jan;22(1):7-10.
Abstract

Families

Razaz N, Joseph KS, Boyce WT, et al.
Children of chronically ill parents: relationship between parental multiple sclerosis and childhood developmental health.
Mult Scler. 2015 Dec 18. [Epub ahead of print]
Abstract
Read the full text of this paper

Other

Bruce JM, Bruce AS, Catley D, et al.
Being kind to your future self: probability discounting of health decision-making.
Ann Behav Med. 2015 Dec 15. [Epub ahead of print]
Abstract

Other treatments

Fjeldstad C, Suárez G, Klingler M, et al.
Dalfampridine effects beyond walking speed in multiple sclerosis.
Int J MS Care. 2015 Nov-Dec;17(6):275-83.
Abstract
Read the full text of this paper

Ford-Johnson L, DeLuca J, Zhang J, et al.
Cognitive effects of modafinil in patients with multiple sclerosis: a clinical trial.
Rehabil Psychol. 2015 Dec 14. [Epub ahead of print]
Abstract

Physical activity

Casey B, Hayes S, Browne C, et al.
What do people with MS want from a web-based resource to encourage increased physical activity behaviour?
Disabil Rehabil. 2015 Dec 18:1-10. [Epub ahead of print]
Abstract

Straudi S, Fanciullacci C, Martinuzzi C, et al.
The effects of robot-assisted gait training in progressive multiple sclerosis: A randomized controlled trial.
Mult Scler. 2015 Dec 10. [Epub ahead of print]
Abstract

Pregnancy and childbirth

Gold R, Phillips JT, Havrdova E, et al.
Delayed-release dimethyl fumarate and pregnancy: preclinical studies and pregnancy outcomes from clinical trials and postmarketing experience.
Neurol Ther. 2015 Dec;4(2):93-104.
Abstract
Read the full text of this paper

Psychological aspects

Wilski M, Tasiemski T, Dąbrowski A.
Body esteem among women with multiple sclerosis and its relationship with demographic, clinical and socio-psychological factors.
Int J Behav Med. 2015 Dec 14. [Epub ahead of print]
Abstract

Quality of life

Tabrizi FM, Radfar M.
Fatigue, sleep quality, and disability in relation to quality of life in multiple sclerosis.
Int J MS Care. 2015 Nov-Dec;17(6):268-74.
Abstract
Read the full text of this paper

Symptoms and symptom management

Raissi A, Bulloch AG, Fiest KM, et al.
Exploration of undertreatment and patterns of treatment of depression in multiple sclerosis.
Int J MS Care. 2015 Nov-Dec;17(6):292-300.
Abstract
Read the full text of this paper

Clancy M, Drerup M, Sullivan AB.
Outcomes of cognitive-behavioral treatment for insomnia on insomnia, depression, and fatigue for individuals with multiple sclerosis: a case series.
Int J MS Care. 2015 Nov-Dec;17(6):261-7.
Abstract
Read the full text of this paper

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