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认知功能可预测多发性硬化症患者的工作能力丧失情况。

Cognitive function predicts work disability among multiple sclerosis patients.

作者信息

Kavaliunas Andrius, Tinghög Petter, Friberg Emilie, Olsson Tomas, Alexanderson Kristina, Hillert Jan, Karrenbauer Virginija Danylaite

机构信息

Department of Clinical Neuroscience, Karolinska Institutet, Sweden.

Red Cross University College, Sweden.

出版信息

Mult Scler J Exp Transl Clin. 2019 Jan 14;5(1):2055217318822134. doi: 10.1177/2055217318822134. eCollection 2019 Jan-Mar.

Abstract

BACKGROUND

In multiple sclerosis various aspects of cognitive function can be detrimentally affected. More than that, patients´ employment and social functioning is likely to be impacted.

OBJECTIVE

To determine whether work disability among multiple sclerosis patients could be predicted by the symbol digit modalities test.

METHODS

A register-based cohort study was conducted. Individual data on work disability, operationalised as annual net days of sickness absence and/or disability pension were retrieved at baseline, when the symbol digit modalities test was performed, after one-year and 3-year follow-up for 903 multiple sclerosis patients. The incidence rate ratios for work disability were calculated with general estimating equations using a negative binomial distribution and were adjusted for gender, age, educational level, family composition, type of living area and physical disability.

RESULTS

After one year of follow-up, the patients in the lowest symbol digit modalities test quartile were estimated to have a 73% higher rate of work disability when compared to the patients in the highest symbol digit modalities test quartile (incidence rate ratio 1.73, 95% confidence interval 1.42‒2.10). This estimate after 3-year follow-up was similar (incidence rate ratio 1.68, 95% confidence interval 1.40‒2.02).

CONCLUSION

Cognitive function is to a high extent associated with multiple sclerosis patients' future work disability, even after adjusting for other factors.

摘要

背景

在多发性硬化症中,认知功能的各个方面都可能受到不利影响。不仅如此,患者的就业和社会功能也可能受到影响。

目的

确定符号数字模式测验是否能够预测多发性硬化症患者的工作残疾情况。

方法

开展了一项基于登记的队列研究。对于903例多发性硬化症患者,在基线时(即进行符号数字模式测验时)、1年随访期后和3年随访期后,获取了关于工作残疾的个体数据,工作残疾定义为年度净病假天数和/或残疾抚恤金。使用负二项分布的广义估计方程计算工作残疾的发病率比,并对性别、年龄、教育水平、家庭构成、居住地区类型和身体残疾进行了调整。

结果

随访1年后,符号数字模式测验得分处于最低四分位数的患者,其工作残疾率比得分处于最高四分位数的患者高73%(发病率比1.73,95%置信区间1.42‒2.10)。3年随访后的估计结果相似(发病率比1.68,95%置信区间1.40‒2.02)。

结论

即使在对其他因素进行调整之后,认知功能在很大程度上仍与多发性硬化症患者未来的工作残疾相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d96/6350142/525bdcabf66c/10.1177_2055217318822134-fig1.jpg

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