Information processing speed (IPS) impairment is a disabling cognitive symptom often present in people with multiple sclerosis (PwMS). IPS is the foundation of higher order cognitive processes, and...Show moreInformation processing speed (IPS) impairment is a disabling cognitive symptom often present in people with multiple sclerosis (PwMS). IPS is the foundation of higher order cognitive processes, and therefore IPS dysfunction significantly lowers quality of live. Early identification of PwMS at risk for IPS decline is necessary in order to provide timely cognitive rehabilitation and psychoeducation. As such, identifying who will or will not develop IPS impairment over time is important. Here, we investigated retrospectively which characteristics were associated with IPS impairment in a real-life sample of 218 PwMS (158 female; age M=47±12.7; baseline disease duration M=9.8±9.9) that visited the Noorderhart Rehabilitation and MS Centre in Overpelt (Belgium). IPS decline was determined based on performance on the Symbol Digit Modalities Test (SDMT), with two threshold settings: (1) minus 1.5 standard deviation, and (2) minus eight points decline of raw score. Next to SDMT scores, demographic information was collected (sex, age, educational level) as well as MS-specific characteristics (disease severity [measured with the EDSS], disease duration, MS subtype), and psychological measures (fatigue [FSMC], depression and anxiety [HADS]). The analyses at baseline showed that EDSS score (impaired median=4 [2.5-6]; preserved median=2 [1.1-3.5]; d=0.9), disease duration (impaired M=11±10.8; preserved M=7±7.6; ƞ2=0.04), MS subtype (V=0.26), and perceived fatigue (impaired M=68.2±18.5; preserved M=53.5±20.8; d=0.75) were significantly higher/ progressive for IPS impaired PwMS (N=134) compared to preserved (N=84). Measured over time (average of three years), nine PwMS (N=50) were found to decline from preserved IPS functioning into impairment, independent of threshold setting for impairment. However, for both thresholds no longitudinal differences between IPS impaired and preserved PwMS were found. Our results demonstrate that IPS impairment is very prevalent in PwMS (61% at baseline) and is associated with higher levels of disability (more progressive subtype, longer disease duration, higher disease severity) and more fatigue. Worsening of these factors indicate the need to pay extra attention to IPS functioning. Secondly, IPS impairment does not develop quickly, with only a few PwMS (9/50) who decline into IPS impairment in a three-year period. It is recommended to start early with regular measurements of cognitive functioning to detect initial IPS changes.Show less
Background. Multiple sclerosis (MS) is a degenerative disease affecting the central nervous system. Symptoms include fatigue, worsening mobility, and cognitive impairment. Unemployment is common in...Show moreBackground. Multiple sclerosis (MS) is a degenerative disease affecting the central nervous system. Symptoms include fatigue, worsening mobility, and cognitive impairment. Unemployment is common in the MS-community. Within 10 years of disease onset 50-80% of MS-patients will be unemployed. Absenteeism often precedes unemployment. Work absenteeism has been associated with several physical and psychological factors in MS, such as fatigue, and use of maladaptive coping styles. Our aim is to investigate both fatigue and maladaptive coping as possible predictors for work absenteeism. To our knowledge coping and fatigue have not been investigated together with respect to work absenteeism in MS-patients. It is important to study absenteeism to prevent future unemployment as much as possible. Method. We investigated 269 employed MS-patients (age 21-63, Mage = 42.09, SDage = 9.39, 77.3% female) of which 47 had been absent within the last seven days. Participants completed questionnaires regarding fatigue (checklist for individual strength), coping style (coping inventory for stressful situations), and work absenteeism. We conducted three logistic regression analyses in which absenteeism was the dependent variable. Fatigue was investigated with subjective fatigue, motivation, concentration, and physical activity as predictors. Coping style was investigated with task-oriented, emotion-oriented, and avoidant coping as predictors. The last analysis investigated both fatigue and coping as predictors for absenteeism with all previous predictors mentioned. Results. A model in which multidimensional aspects of fatigue predict absenteeism was significant (X2(4) = 30.46, p < .001), fatigue, concentration, and physical activity were significant predictors of absenteeism (Bfatigue = 0.04, p = .036; Bconcentration = 0.07, p = .011, Bphysical_activity = -0.03, p = .032 respectively).Show less
Background. Multiple sclerosis (MS) is a degenerative disease affecting the central nervous system. Symptoms include fatigue, worsening mobility, and cognitive impairment. Unemployment is common in...Show moreBackground. Multiple sclerosis (MS) is a degenerative disease affecting the central nervous system. Symptoms include fatigue, worsening mobility, and cognitive impairment. Unemployment is common in the MS-community. Within 10 years of disease onset 50-80% of MS-patients will be unemployed. Absenteeism often precedes unemployment. Work absenteeism has been associated with several physical and psychological factors in MS, such as fatigue, and use of maladaptive coping styles. Our aim is to investigate both fatigue and maladaptive coping as possible predictors for work absenteeism. To our knowledge coping and fatigue have not been investigated together with respect to work absenteeism in MS-patients. It is important to study absenteeism to prevent future unemployment as much as possible. Method. We investigated 269 employed MS-patients (age 21-63, Mage = 42.09, SDage = 9.39, 77.3% female) of which 47 had been absent within the last seven days. Participants completed questionnaires regarding fatigue (checklist for individual strength), coping style (coping inventory for stressful situations), and work absenteeism. We conducted three logistic regression analyses in which absenteeism was the dependent variable. Fatigue was investigated with subjective fatigue, motivation, concentration, and physical activity as predictors. Coping style was investigated with task-oriented, emotion-oriented, and avoidant coping as predictors. The last analysis investigated both fatigue and coping as predictors for absenteeism with all previous predictors mentioned. Results. A model in which multidimensional aspects of fatigue predict absenteeism was significant (X 2 (4) = 30.46, p < .001), fatigue, concentration, and physical activity were significant predictors of absenteeism (Bfatigue = 0.04, p = .036; Bconcentration = 0.07, p = .011, Bphysical_activity = -0.03, p = .032 respectively). A model in which coping style predicts work absenteeism was non-significant (X 2 (3) = 5.88, p = .118). The model in which both fatigue and coping were investigated was significant (X 2 (7) = 30.80, p < .001), however this model did not yield any additional information. Conclusion. Fatigue, concentration, and physical activity predict work absenteeism for MS-patients. Possible interventions might be CBT or motivational interviewing, both these interventions can be used to minimize work absenteeism.Show less
