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Cognitive impairment, health-related quality of life and vocational status at early stages of multiple sclerosis: a 7-year longitudinal study

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Abstract

The association between cognitive impairment, health-related quality of life (HRQoL) and vocational status has been studied in recent years in cross-sectional studies in multiple sclerosis (MS), but longitudinal data are still lacking. This study assesses this association in a sample of 65 newly diagnosed MS patients followed longitudinally. Each patient underwent a standardised clinical assessment, cognitive tests and the HRQoL SEP-59 questionnaire six months after the MS diagnosis (baseline) and seven years later (y7).Vocational status was also established at baseline and at y7 in MS patients. The HRQoL at baseline was severely reduced in MS patients compared with healthy subjects. The independent predictors for HRQoL composite scores at y7 were the baseline depression score and the memory Z-score. Accordingly, 81.5 % of MS patients worked at baseline and only 54.4 % worked at y7. Among the MS patients who did not work at y7, 72.7 % of them were cognitively impaired, while 27.3 % were unimpaired at baseline. The vocational status at y7 was significantly associated with the baseline IPS Z-score, EDSS and age. Vocational status at y7 and its change over 7 years was significantly associated with cognitive deterioration. IPS or memory dysfunction in the early stages of MS is correlated with a decreased level in health perception, independent of fatigue, depression and physical disability. Cognitive impairment at the diagnosis of MS increases the risk of changing vocational status in MS patients seven years later.

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Acknowledgments

The study was conducted as part of a study supported by the Association pour la Recherche contre la Sclérose en Plaques (ARSEP), France, and Bayer healthcare, SA, France. The sponsors did not participate in any aspects of the design or conduct of the study, including data collection, management, analysis, and interpretation, as well as preparation, review, and approval of the manuscript. Dr. Ruet is a recipient of a fellowship-grant from Fondation pour la Recherche Médicale.

Conflicts of interest

The authors do not have any actual or potential conflict of interest including any financial, personal or other relationships with other people or organisations that could inappropriately influence, or be perceived to influence, their work.

Ethical standard

The patients gave written informed consent before inclusion in the study according to the 1964 Declaration of Helsinki. This study was approved by the local ethics committee.

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Authors and Affiliations

  1. INSERM U.1049 Neuroinflammation, Imagerie et Thérapie de la Sclérose en plaques, Université de Bordeaux, Case 78, 146 rue Léo Saignat, 33076, Bordeaux cedex, France

    Aurélie Ruet, Delphine Hamel, Klaus Petry & Bruno Brochet

  2. CHU de Bordeaux, INSERM-CHU CIC-P 0005, and Services de Neurologie, 33076, Bordeaux, France

    Aurélie Ruet, Mathilde Deloire, Jean-Christophe Ouallet & Bruno Brochet

Authors
  1. Aurélie Ruet
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  2. Mathilde Deloire
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  3. Delphine Hamel
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  4. Jean-Christophe Ouallet
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  5. Klaus Petry
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  6. Bruno Brochet
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Corresponding author

Correspondence to Bruno Brochet.

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Ruet, A., Deloire, M., Hamel, D. et al. Cognitive impairment, health-related quality of life and vocational status at early stages of multiple sclerosis: a 7-year longitudinal study. J Neurol 260, 776–784 (2013). https://doi.org/10.1007/s00415-012-6705-1

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  • DOI: https://doi.org/10.1007/s00415-012-6705-1

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