title: Cognitive function alone is a poor predictor of health-related quality of life in employed patients with MS: results from a cross-sectional study.
abstract: Depression, anxiety, disease severity, and cognitive functions impact on the quality of life of people with MS. However, the majority of studies were not based on multivariate models and did not target employed patients. The aim of this study was to investigate predictors of HRQoL in persons with MS in the workforce considering cognitive, psychological, disease severity, and disability-related variables.
  
  
  
  Cross-sectional study. Hierarchical block regression analyses were conducted to identify predictors of physical and mental components of HRQoL, measured with the MSQOL-54. Candidate predictors included cognitive functioning (a selection of Rao's BRB-NT), sample features (age, education, MS duration), depressive symptoms (BDI-II), anxiety (STAI-Y), disability (WHODAS 2.0), and MS severity (EDSS): those that correlated with PCS and MCS with p < .250 and those that correlated with other predictors with coefficients >.800 were excluded from regression analyses.
  
  
  
  In total, 181 patients (60.8% females, mean age 39.6, median EDSS 1.5) were included. In both models, cognitive variables had a poor explicative power. The models improved significantly when psychological, as well as, disease severity and disability variables were added. R(2) of complete models was 0.732 for the physical component, 0.697 for the mental one: BDI-II, STAI-State and, some WHODAS 2.0 scales were significant predictors of HRQoL.
  
  
  
  Monitoring anxiety, depressive symptoms, and level of disability through self-reported questionnaires may provide useful suggestions to improve the HRQoL of persons with MS in the workforce, permitting to address possible problems in the work context and plan corrective actions.
authors.affiliation: a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Ambra Mara
authors.initials: AM
authors.lastname: Giovannetti
authors.affiliation: b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Schiavolin
authors.affiliation: a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Greta
authors.initials: G
authors.lastname: Brenna
authors.affiliation: a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Brambilla
authors.affiliation: a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Confalonieri
authors.affiliation: c Scientific Directorate , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cortese
authors.affiliation: b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Venusia
authors.initials: V
authors.lastname: Covelli
authors.affiliation: a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Frangiamore
authors.affiliation: b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
authors.affiliation: a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Mantegazza
authors.affiliation: a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Moscatelli
authors.affiliation: d Scientific Research Area , Italian Foundation of Multiple Sclerosis , Genoa , Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Ponzio
authors.affiliation: a Department of Neuroimmunology and Neuromuscolar Disease , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Torri Clerici
authors.affiliation: d Scientific Research Area , Italian Foundation of Multiple Sclerosis , Genoa , Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Zaratin
authors.affiliation: b Neurology, Public Health and Disability Unit , Neurological Institute C. Besta IRCCS Foundation , Milan , Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Raggi
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D003071:Cognition; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004185:Disability Evaluation; D004651:Employment / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology*; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: MS-QOL-54; anxiety; cognitive functions; depression; disability evaluation