title: Which features of Parkinson's disease predict earlier exit from the workforce?
abstract: BACKGROUND
  Few objective data exist regarding predictors of leaving the workforce (LWF) in Parkinson's disease (PD).
  
  
  METHODS
  Employed PD patients were followed prospectively. Baseline demographics, disease duration, and measures of disease severity, cognition, disability, and mental health were compared between patients working at last follow-up versus those who left the workforce using student's t-tests and multivariate analyses controlling for age, gender, and PD duration.
  
  
  RESULTS
  Of 419 employed patients, 224 had left the workforce by last follow-up. Patients who left the workforce were more likely to be older, female, have lower-income, and have longer PD duration. LWF patients had greater baseline depression, anxiety, and overall psychiatric distress. PD severity did not differ between groups.
  
  
  CONCLUSIONS
  Demographics, disease duration, and mental health contribute to LWF, but not motor severity. Age, gender and income contributions are difficult to modify but important to recognize. Worse baseline mental health is associated with LWF, suggesting a potential target for intervention.
authors.affiliation: Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: marmstrong@som.umaryland.edu.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Armstrong
authors.affiliation: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Ann L
authors.initials: AL
authors.lastname: Gruber-Baldini
authors.affiliation: Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Reich
authors.affiliation: Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Fishman
authors.affiliation: Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Lachner
authors.affiliation: Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Shulman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D004185:Disability Evaluation; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016526:Workload
keywords: Depression; Disability; Employment; Parkinson's disease; Retirement; Work