Risk factors for unemployment with multiple sclerosis vary by age, study finds

Reviewed by James Ives, M.Psych. (Editor)Oct 24 2019

A recent study by Kessler Foundation researchers explored numerous factors that contribute to the high unemployment rate among individuals of different ages with multiple sclerosis (MS). This is the first investigation to consider age within the context of disease- and person-specific factors affecting employment in MS. The article, "Unemployment in multiple sclerosis across the ages: How factors of unemployment differ among the decades of life," was epublished on September 14, 2019 by the Journal of Health Psychology.

The authors are Lauren Strober, PhD, of Kessler Foundation, and Renee M. Callanan, a former intern at the Foundation. Link to abstract: https://www.ncbi.nlm.nih.gov/pubmed/31522567

Multiple sclerosis affects people of working age; therefore, the impact on employment is substantial. Because of the complexities of MS and the diverse population affected, a holistic approach is needed when examining the factors contributing to the high rates of unemployment in the MS population, estimated at 40 to 80%.

The cross-sectional study included 221 employed individuals with multiple sclerosis, aged 20 to 64, grouped by those considering reducing work hours or leaving the workplace, called the "considering group" (27%), and those expressing no intent to change their work status, the "staying group" (73%). Each group was subdivided into four age groups: 30-59 (overall sample), 30-39, 40-49, and 50-59; the group of 20-29 year olds was excluded due to small sample size. The "considering group" comprised an increasing percentage of each successive decade: 30-39 (22%), 40-49 (26%), and 50-59 (32%).

In addition to age, gender, education and disease duration, researchers assessed disease factors, including fatigue, sleep disorders, and pain; psychological factors including anxiety and depression; and person-specific factors, including personality and coping style.

For all participants, there was no difference with regard to demographic and disease variables between the "considering" and "staying" groups, with the exception of more participants with progressive MS in the "considering group." Factors that differentiated those considering and those staying were consistent with previous findings and included disease symptoms (fatigue, pain), psychological factors (depression, anxiety), and person-specific factors (self-efficacy, personality, and coping). However, looking at each decade revealed differences in reasons for considering leaving the workforce. Disease symptoms were cited more among 30-39 year olds (pain) and 50-59 year olds (fatigue), while psychological reasons predominated among 40-49 year olds.

Our findings suggest that physical symptoms and how the individual manages them are greater issues for the youngest and oldest decades, while psychological issues predominate among the middle-aged. Professionals who counsel individuals with MS about important decisions such as leaving the workforce, need to be aware of the influence of age on employment decisions, within the context of biological and psychosocial factors."

Dr. Lauren Strober, senior research scientist in the Center for Neuropsychology and Neuroscience Research