title: Longitudinal changes in sickness absence and disability pension, and associations between disability pension and disease-specific and contextual factors and functioning, in people with multiple sclerosis.
abstract: BACKGROUND
  Even though it is well known that disability due to MS is highly associated with employment status, the long-term longitudinal perspective on sickness absence and disability pension over the MS trajectory is lacking. In addition, further knowledge of risk factors for future disability pension is needed.
  
  
  OBJECTIVE
  To explore long-term longitudinal changes in the prevalence of sickness absence and disability pension in people with MS (PwMS), as well as to explore associations between disease-specific factors, contextual factors and functioning, and the outcome of future full-time disability pension.
  
  
  METHODS
  A prospective, population-based survival cohort study, with a nine year follow-up, including 114 PwMS was conducted by combining face-to-face collected data and register-based data.
  
  
  RESULTS
  The prevalence of full-time disability pension increased from 20% to 50%, however 24% of the PwMS had no disability pension at all at end of follow-up. Sex, age, disease severity and impaired manual dexterity were associated with future full-time disability pension.
  
  
  CONCLUSIONS
  The large increase in prevalence of PwMS on full-time disability pension during the MS trajectory, calls for the development and implementation of evidence-based interventions, aiming at keeping PwMS in the work force. Modifiable factors, such as manual dexterity should be targeted in such interventions.
authors.affiliation: Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE - 141 83 Stockholm, Sweden; Department of Physiotherapy, Karolinska University Hospital, SE - 141 86 Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Chruzander
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE - 171 77 Stockholm, Sweden; Red Cross University College, SE - 114 28 Stockholm, Sweden.
authors.forename: Petter
authors.initials: P
authors.lastname: Tinghög
authors.affiliation: Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE - 141 83 Stockholm, Sweden; Department of Physiotherapy, Karolinska University Hospital, SE - 141 86 Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ytterberg
authors.affiliation: Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE - 141 83 Stockholm, Sweden; Department of Physiotherapy, Karolinska University Hospital, SE - 141 86 Stockholm, Sweden; Division of Neuroscience, Department of Clinical Neuroscience, Karolinska Institutet, SE - 171 77 Stockholm, Sweden.
authors.forename: Lotta
authors.initials: L
authors.lastname: Widén Holmqvist
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE - 171 77 Stockholm, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
authors.affiliation: Division of Neuroscience, Department of Clinical Neuroscience, Karolinska Institutet, SE - 171 77 Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Hillert
authors.affiliation: Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE - 141 83 Stockholm, Sweden; Department of Physiotherapy, Karolinska University Hospital, SE - 141 86 Stockholm, Sweden. Electronic address: sverker.johansson@ki.se.
authors.forename: Sverker
authors.initials: S
authors.lastname: Johansson
mesh_terms: D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology* / Q000523:psychology; D010415:Pensions / Q000706:statistics & numerical data; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012720:Severity of Illness Index; D013548:Sweden / Q000453:epidemiology
keywords: Disability pension; Longitudinal studies; Multiple sclerosis; Risk factors; Sick-leave; Sociodemographics