Predicting unemployment in people ageing with multiple sclerosis.

Background: Older adults who have a disability report higher rates of unemployment than older adults without a disability and one of the significant risks associated with disability is poverty. Approximately 90% of individuals diagnosed with MS are employed before their diagnosis, but as few as 30% remain working in as little as 5 years after diagnosis. About 40% of unemployed people with MS want to return to work. Little is known about changes in employment status for people with MS as they age. Objectives: Examine the predictors of unemployment stratified by age groups in people with MS. Methods: Data were analyzed from a cross-sectional survey of community-dwelling people with MS (n = 1,271) collected in 2006. Participants were recruited from the Greater Washington Chapter of the USA National MS Society (NMSS) and were eligible if they self-reported a diagnosis of MS and were at least 18 years of age. Measures of secondary conditions, employment status, history of MS, and demographic characteristics were included in the survey.A stratified, prediction logistical regression was run across 4 age groups (18 – 34 yrs, 35 – 44yrs, 45 – 54 yrs, 55-64 yrs) and gender, duration of MS, EDSS Mobility, MS subtype, education level, problems thinking, cognitive fatigue, physical fatigue, pain, depression, and sleep problems were included as predictors. Results: The percentage of unemployed among people with MS climbed from 39% of 18-34 yr olds to 47% of 35-44 yr olds, to 58% of 45-54 yr olds to 75% of 55-64 yr olds. Predictors of unemployment were similar throughout the 3 middle age groups (35 – 64 yrs) and included duration of disease, EDSS mobility level, problems thinking.Predictors differed in the youngest age group (18-34 yrs) where only education level was a statistically significant. Also, the contribution of pain as a significant predictor only occurred in the 35-44 age group. Conclusions: People with MS are more likely to be unemployed when their MS progresses including mobility limitations as well as cognitive impairments. Surprisingly, secondary conditions of fatigue, depression, and sleep problems were not associated unemployment. Programs and services to support employment should target people with MS who are experiencing mobility and cognitive changes as they age.