Toward the Search for Clinical and Cognitive Variables that Affect Employment in LATAM: a Multicenter Study.

Abstract

Background: In response to rising unemployment rates among people with multiple sclerosis (PwMS) and poor working conditions in Latin America (LATAM), MS experts established the Quality-of-Life working group. This study aims to: (i) describe occupational outcomes and employment status among PwMS in LATAM; (ii) investigate the relationship between different levels of disability and ES; and (iii) Quantify accommodation use and explore potential clinical, cognitive, and sociodemographic predictors of job accommodations in LATAM.

Methods: A total of 86 PwMS were recruited from Argentina, Chile, Colombia, Mexico, and Paraguay, of whom 79 (91%) had a relapsing-remitting phenotype and 61 (70.9%) were women. The assessment protocol included the Brief Visual Memory Scale (BVMS), the Brief International Cognitive Assessment for MS (BICAMS), the MS Neuropsychology Screening Questionnaire, the Beck Depression Inventory II (BDI-II), the Fatigue Severity Scale (FSS), and a socioeconomic status (SES) survey.

Results: (i) Based on employment status characteristics, 47 PwMS (54.6%) were classified into the work-stable group, 18 PwMS (20.9%) into the work-challenged group, and 21 PwMS (24.4%) into the work-loss group, additionally clinical and sociodemographic characteristics are described. (ii) Hierarchical cluster analysis ranked PwMS into three groups based on cognitive and physical disability levels, showing that a lower level of disability was linked to a higher likelihood of maintaining stable employment. (iii) Job accommodations were predicted by greater self-awareness of cognitive impairment, higher socioeconomic status, higher education, and higher physical disability, all contributing to increased use of workplace accommodations.

Conclusion: Physical and neuropsychological disability increase the likelihood of being classified in the work-loss group, while factors such as self-awareness of cognitive impairment, socioeconomic status, level of disability, and education are associated with greater utilization of job accommodations. The work-loss rate among PwMS in LATAM was nearly three times higher than the general unemployment rate, underscoring the significant impact of MS on employment.