A number of different factors appear to play a role in job retention rates for patients with multiple sclerosis (MS), according to a study published in Archives of Physical Medicine and Rehabilitation.

The most impactful factors of those studied were related to MS severity and complications with time since diagnosis, fatigue, and more severe symptoms having the largest effects of the factors studied. Compared to patients who were diagnosed with MS 9 years or less, patients who were diagnosed 20 years or more had a 32.0% chance of being employed (odds ratio [OR], 0.15).

Multiple, severe symptoms in patients resulted in an OR of 0.12 for job retention when compared to patients with no symptoms. For patients who self-reported fatigue, the OR for job retention was only 0.23 compared to those who did not report fatigue.

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Patients with MS with a progressive course also had a much lower job retention rate (OR, 0.54) compared to patients with relapsing-remitting MS. Cognitive impairment had a much lower impact on job retention with minimal-mild cognitive disability conferring a 0.80 OR and moderate to total cognitive disability conferring a 0.65 OR compared to patients with normal cognition.

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Surprisingly, pre-MS employment characteristics including hours spent working, income level, and education level were not strong predictors for long-term outcomes of job retention. Prediagnosis education level only affected job retention for those who achieved greater than a high school diploma with no additional odds of retention for increasing education. The only significant employment characteristic was that workers in the field of production, transportation, and materials moving had significantly lower odds of job retention.

Age and race were also found to be significant factors related to employment. Patients aged between 50 years to 59 years and 60 years and above had substantially lower odds of job retention (OR, 0.49 and 0.45, respectively) compared to those aged 39 years or less. Also, non-Hispanic Blacks and Hispanics had lower odds (OR, 0.52 and 0.45, respectively) compared to non-Hispanic White patients.

“MS factors, such as severity and complications, are stronger explanatory factors for job retention than pre-diagnostic employment and vocational history. Compared to non-Hispanic Whites, non-Hispanic blacks had lower odds of job retention, which may speak to the need for targeted intervention strategies for these individuals,” the authors summarized.

A total of 1126 patients with MS who were employed at the time of MS diagnosis were included in the study. Most participants were women (76.1%) with the majority being non-Hispanic White (66.4%) and aged between 40 years to 49 years (33.0%).


Krause JS, Dismuke-Greer CL, Rumrill P, Reed K, Jarnecke M, Backus D. Job retention among individuals with multiple sclerosis: relationship with pre-diagnostic employment and education; demographic characteristics; and disease course, severity, and complications. Arch Phys Med Rehabil. Published online June 17, 2022. doi:10.1016/j.apmr.2022.05.013