A correlation between cognitive dysfunction and employment status in multiple sclerosis — a systematic literature review

INTRODUCTION: Multiple sclerosis (MS) is a disease of the central nervous system (CNS) with a complex pathogenesis characterized by inflammation, demyelination, and progressive neurodegeneration. Cognitive impairment (CI) is a common manifestation of MS, with a prevalence ranging from 40% to 70% of patients. It also appears to be one of the factors involved in deterioration of work ability, which negatively affects patients' independence and carries a substantial socioeconomic burden. MATERIAL AND METHODS: We aimed to summarize the most recent findings regarding the relationship between CI and employment status in MS. PubMed and Embase were searched in accordance with PRISMA guidelines, which resulted in the inclusion of the 37 most appropriate studies. RESULTS: Patients with MS scored significantly worse on cognitive assessment tests than healthy controls. Significant correlations were found between worse performance in different cognitive domains and unemployment. Moreover, some studies reported that CI may also predict future vocational deterioration in patients with MS. CONCLUSIONS: Cognitive dysfunction may play an important role in the deterioration of employment status among patients with MS. Of the analyzed neuropsychological tests, the Symbol Digit Modalities Test (SDMT) appears to be the most suitable tool for cognitive evaluation in this patient group.