Disease and Demographic Characteristics Associated with Unemployment Among Working-Age Adults with Multiple Sclerosis

Previous studies of employment in people with multiple sclerosis (MS) have been inconsistent in identifying associated factors, and few have examined the role of secondary health conditions. The goal of this study was to examine the association of these health conditions, including pain, fatigue, depression, sleep problems, anxiety, and incontinence, with employment status in individuals with MS. Data were collected using a cross-sectional self-report survey of 1271 people with MS, of whom 1124 were between the ages of 18 and 65 years and provided employment information. Self-report of employment status was used as an outcome variable for multivariate logistic regression. In total, 40.4% (n = 454) of surveyed individuals were employed half-time or more. Variables significantly associated with unemployment in the multivariate model were severity of disease (as measured by Expanded Disability Status Scale score), difficulties in thinking, female sex, increased age, and increased duration of MS. The symptoms of fatigue, pain, depression, and anxiety were not significantly associated with employment status in this sample. The combined impact of cognitive changes and overall severity of mobility impairment significantly influenced employment status in this community sample. Future longitudinal studies are needed to better elucidate the circumstances surrounding changes in employment status and identify points at which vocational rehabilitation interventions might be most effective.