Contributions
Abstract: P839
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: The majority of patients with MS are unable to retain employment. Literature has shown that cognitive (dys)functioning (among others) plays an important role in work participation. However, most studies are cross-sectional. We examined the relation between cognitive (dys)functioning and changes in work status after one year.
Methods: In the context of the MS@Work study, 181 workers with relapsing-remitting MS (Mean (SD) age = 42 (10) years; 79.2% female) were clinically examined and completed questionnaires on demographics, health and work functioning. Participants were divided into Stable Employment Status (SES) (N = 147) and Decreased Employment Status (DES) (N = 34). Patient with MS were included in the DES group when reporting either a deterioration in work hours or responsibilities due to MS, one year after baseline assessment. Z-scores were calculated for baseline cognitive, mood and fatigue scores based on a matched healthy control group (n=60). Composite Z-scores were calculated for the following DSM-V cognitive domains: complex attention, executive functioning, learning and memory, language, perceptual-motor functioning and additionally for self-reported cognition . Group comparisons and logistic regression analysis were conducted to examine whether cognitive functioning predicted employment status after one year. Physical functioning, age, sex, education and composite scores for mood and fatigue were included as confounders.
Results: DES and SES groups did not differ in age, sex, education, complex attention, memory, language, perceptual-motor functioning and mood. We observed lower executive functioning (U = 1444.0, p=. 001), lower physical functioning (U = 1582.5, p = .01), more cognitive problems (U = 1570.0, p = .003) and higher fatigue (U = 1475.5, p =.001) in the DES as compared with the SES group. In a logistic regression model, lower executive functioning (B = -.1.06, p = .004) and higher fatigue (B= .58, p = .007) were retained as independent predictors of DES (R2 = .14 (Cox & Snell), .22 (Nagelkerke), X2(2) = 23.45, p< .001).
Conclusion: In workers with MS, lower executive functioning and higher levels of fatigue predicted decreases in work status due to MS after one year. Although a large part of the variance remains unexplained, the supposed role of executive functioning and fatigue in decreasing employment status is in accordance with previous research.
Disclosure: D.A.M. van Gorp received honoraria for presentations from Sanofi Genzyme.
K. van der Hiele received honoraria for consultancies, presentations and advisory boards from Sanofi Genzyme and Merck Serono.
M.A.P. Heerings reports no competing interests.
P.J. Jongen received honoraria from Bayer, Merck Serono and Teva for contributions to symposia as a speaker or for educational or consultancy activities.
I. van Lieshout reports no competing interests.
J.J.L. van der Klink reports no competing interests.
M.F. Reneman reports no competing interests
E.P.J. Arnoldus reports personal fees from honoraria for lectures, and honoraria for advisory boards from Teva, Merck Serono, Sanofi Genzyme, Biogen and Novartis.
E.A.C. Beenakker reports no competing interests.
H.M. Bos reports no competing interests.
J.J.J. van Eijk received honoraria for lectures, travel grants and honoraria for advisory boards from Teva, Merck Serono, Sanofi Genzyme, Biogen, Roche and Novartis.
J. Fermont reports no competing interests.
S.T.F.M. Frequin received honoraria for lectures, grants for research, and advisory boards from Teva, Merck Serono, Sanofi Genzyme, Biogen, Novartis, and Roche.
B.M. van Geel reports no competing interests.
K. de Gans reports no competing interests.
G.J.D. Hengstman reports grants and personal fees from Biogen, Novartis, Teva, Merck Serono, and Sanofi Genzyme.
E. Hoitsma reports honoraria for lectures, travel grants and honoraria for advisory boards from Novartis, Teva, Roche, Merck Serono, Sanofi Genzyme, Biogen and Bayer.
R.M.M. Hupperts received honoraria for lectures, grants for research and honoraria for advisory boards from Merck Serono, Novartis, Sanofi Genzyme and Biogen.
J.W.B. Moll reports no competing interests.
J.P. Mostert reports personal fees from Novartis, Merck Serono, Genzyme and Teva
P.H.M. Pop reports no competing interests
W.I.M. Verhagen received honoraria for lectures from Biogen and Merck Serono, reimbursement for hospitality from Biogen, Teva, Sanofi Genzyme and Merck Serono, and honoraria for advisory boards from Merck Serono.
D. Zemel received honoraria for advisory boards from Novartis, Merck Serono, Sanofi Genzyme and Biogen.
L.H. Visser received honoraria for lectures, grants for research and honoraria for advisory boards from Sanofi Genzyme, Merck Serono, Novartis and Teva.
H. Middelkoop reports no competing interests.
Source of funding: The MS@Work study is financed by the National Multiple Sclerosis Foundation, Teva Pharmaceuticals and ZonMw (TOP Grant, project number: 842003003).
Abstract: P839
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: The majority of patients with MS are unable to retain employment. Literature has shown that cognitive (dys)functioning (among others) plays an important role in work participation. However, most studies are cross-sectional. We examined the relation between cognitive (dys)functioning and changes in work status after one year.
Methods: In the context of the MS@Work study, 181 workers with relapsing-remitting MS (Mean (SD) age = 42 (10) years; 79.2% female) were clinically examined and completed questionnaires on demographics, health and work functioning. Participants were divided into Stable Employment Status (SES) (N = 147) and Decreased Employment Status (DES) (N = 34). Patient with MS were included in the DES group when reporting either a deterioration in work hours or responsibilities due to MS, one year after baseline assessment. Z-scores were calculated for baseline cognitive, mood and fatigue scores based on a matched healthy control group (n=60). Composite Z-scores were calculated for the following DSM-V cognitive domains: complex attention, executive functioning, learning and memory, language, perceptual-motor functioning and additionally for self-reported cognition . Group comparisons and logistic regression analysis were conducted to examine whether cognitive functioning predicted employment status after one year. Physical functioning, age, sex, education and composite scores for mood and fatigue were included as confounders.
Results: DES and SES groups did not differ in age, sex, education, complex attention, memory, language, perceptual-motor functioning and mood. We observed lower executive functioning (U = 1444.0, p=. 001), lower physical functioning (U = 1582.5, p = .01), more cognitive problems (U = 1570.0, p = .003) and higher fatigue (U = 1475.5, p =.001) in the DES as compared with the SES group. In a logistic regression model, lower executive functioning (B = -.1.06, p = .004) and higher fatigue (B= .58, p = .007) were retained as independent predictors of DES (R2 = .14 (Cox & Snell), .22 (Nagelkerke), X2(2) = 23.45, p< .001).
Conclusion: In workers with MS, lower executive functioning and higher levels of fatigue predicted decreases in work status due to MS after one year. Although a large part of the variance remains unexplained, the supposed role of executive functioning and fatigue in decreasing employment status is in accordance with previous research.
Disclosure: D.A.M. van Gorp received honoraria for presentations from Sanofi Genzyme.
K. van der Hiele received honoraria for consultancies, presentations and advisory boards from Sanofi Genzyme and Merck Serono.
M.A.P. Heerings reports no competing interests.
P.J. Jongen received honoraria from Bayer, Merck Serono and Teva for contributions to symposia as a speaker or for educational or consultancy activities.
I. van Lieshout reports no competing interests.
J.J.L. van der Klink reports no competing interests.
M.F. Reneman reports no competing interests
E.P.J. Arnoldus reports personal fees from honoraria for lectures, and honoraria for advisory boards from Teva, Merck Serono, Sanofi Genzyme, Biogen and Novartis.
E.A.C. Beenakker reports no competing interests.
H.M. Bos reports no competing interests.
J.J.J. van Eijk received honoraria for lectures, travel grants and honoraria for advisory boards from Teva, Merck Serono, Sanofi Genzyme, Biogen, Roche and Novartis.
J. Fermont reports no competing interests.
S.T.F.M. Frequin received honoraria for lectures, grants for research, and advisory boards from Teva, Merck Serono, Sanofi Genzyme, Biogen, Novartis, and Roche.
B.M. van Geel reports no competing interests.
K. de Gans reports no competing interests.
G.J.D. Hengstman reports grants and personal fees from Biogen, Novartis, Teva, Merck Serono, and Sanofi Genzyme.
E. Hoitsma reports honoraria for lectures, travel grants and honoraria for advisory boards from Novartis, Teva, Roche, Merck Serono, Sanofi Genzyme, Biogen and Bayer.
R.M.M. Hupperts received honoraria for lectures, grants for research and honoraria for advisory boards from Merck Serono, Novartis, Sanofi Genzyme and Biogen.
J.W.B. Moll reports no competing interests.
J.P. Mostert reports personal fees from Novartis, Merck Serono, Genzyme and Teva
P.H.M. Pop reports no competing interests
W.I.M. Verhagen received honoraria for lectures from Biogen and Merck Serono, reimbursement for hospitality from Biogen, Teva, Sanofi Genzyme and Merck Serono, and honoraria for advisory boards from Merck Serono.
D. Zemel received honoraria for advisory boards from Novartis, Merck Serono, Sanofi Genzyme and Biogen.
L.H. Visser received honoraria for lectures, grants for research and honoraria for advisory boards from Sanofi Genzyme, Merck Serono, Novartis and Teva.
H. Middelkoop reports no competing interests.
Source of funding: The MS@Work study is financed by the National Multiple Sclerosis Foundation, Teva Pharmaceuticals and ZonMw (TOP Grant, project number: 842003003).