认知功能作为复发缓解型多发性硬化症患者就业状况的预测因素：一项为期 2 年的纵向研究。

Cognitive functioning as a predictor of employment status in relapsing-remitting multiple sclerosis: a 2-year longitudinal study.

机构信息

National Multiple Sclerosis Foundation, Mathenesserlaan 378, 3023 HB, Rotterdam, The Netherlands.

Department of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, PO Box 9555, 2300 RB, Leiden, The Netherlands.

出版信息

Neurol Sci. 2019 Dec;40(12):2555-2564. doi: 10.1007/s10072-019-03999-w. Epub 2019 Jul 19.

DOI:10.1007/s10072-019-03999-w

PMID:31321625

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6848242/

Abstract

BACKGROUND

Cognitive functioning has been linked to employment outcomes in multiple sclerosis (MS) in cross-sectional studies. Longitudinal studies are however lacking and previous studies did not extensively examine executive functioning.

OBJECTIVES

We examined whether baseline cognitive functioning predicts a change in employment status after 2 years, while taking into account mood, fatigue and disability level.

METHODS

A total of 124 patients with relapsing-remitting MS (pwMS) and 60 healthy controls were included. They underwent neurological and neuropsychological examinations and completed online questionnaires. PwMS were divided into a stable and deteriorated employment status group (SES and DES), based on employment status 2 years after baseline. We first examined baseline differences between the SES and DES groups in cognitive functioning, mood, fatigue and disability level. A logistic regression analysis was performed, with change in employment status (SES/DES) as dependent variable.

RESULTS

The DES group included 22% pwMS. Group differences were found in complex attention, executive functioning, self-reported cognitive functioning, fatigue and physical disability. More physical disability (OR = 1.90, p = 0.01) and lower executive functioning (OR = 0.30, p = 0.03) were retained as independent predictors of DES (R = 0.22, p ≤ 0.001).

CONCLUSIONS

Baseline physical disability and executive functioning, but none of the other variables, moderately predicted a deterioration in employment status 2 years later.

TRIAL REGISTRATION

This observational study is registered under NL43098.008.12: 'Voorspellers van arbeidsparticipatie bij mensen met relapsing-remitting Multiple Sclerose'. This study is registered at the Dutch CCMO register (https://www.toetsingonline.nl).

摘要

背景

在横断面研究中，认知功能与多发性硬化症（MS）患者的就业结果相关。然而，纵向研究却缺乏，并且先前的研究并未广泛检查执行功能。

目的

我们研究了基线认知功能是否可以预测 2 年后就业状况的变化，同时考虑到情绪、疲劳和残疾程度。

方法

共纳入 124 例复发缓解型多发性硬化症（pwMS）患者和 60 例健康对照者。他们接受了神经学和神经心理学检查，并完成了在线问卷。根据基线后 2 年的就业状况，将 pwMS 分为稳定和恶化的就业状况组（SES 和 DES）。我们首先比较了 SES 和 DES 组之间在认知功能、情绪、疲劳和残疾水平上的基线差异。采用逻辑回归分析，以就业状况的变化（SES/DES）为因变量。