An observational study of work quality and cognitive function in the developing world: Perspectives from Argentina on multiple sclerosis

BackgroundNorth America and Europe clarified links between cognitive, psychological, and physical disability factors and risk for job loss of people with multiple sclerosis (PwMS), that are not well understood in a spanish-speaking South American countries with higher poverty and unemployment rates.ObjectivesReplicate the prevalence of Employment Status (ES) in PwMS from the previous study in Argentina and analyze the differences between ES groups -work-stable, work-challenged or work-loss- in demographic, clinical and cognitive variables. To compare ES between PwMS and healthy controls (HCs) and to identify work challenges, job types, disability assistance, and work-place accommodations among patients in Argentina.Methods80 PwMS and 80 HCs were enrolled in a case-control design. All participants were examined with the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and Buffalo Vocational Monitoring Survey (BVMS), to explore ES and negative work events (NWEs), work-accommodations, work hours and job types.ResultsPwMS showed worse ES than HCs (PwMS vs. HCs): work-challenged 51.2% vs. 90%, work-challenged 25% vs. 6.2% & work-loss 23.8% vs. 3.8%. In PwMS there were significant differences in SDMT scores between the work-stable and both the work- challenged (p < 0.01) and the work-loss group (p < 0.01). Also work-stable and work- challenged groups had better performance on CVLT (p < 0.05), and BVMT-R (p < 0.05) compared with the work-loss group. PwMS reported more NWEs and accommodations than HCs. Similar working hours and job types were found.ConclusionPwMS has worse vocational outcomes compared to HCs. Deficits in processing speed and physical disability may contribute to the decline in ES among PwMS.