title: Sick leave and disability pension before and after diagnosis of multiple sclerosis.
abstract: Multiple sclerosis (MS) is associated with considerable morbidity and serious disability, but little is known of the long-term impact of the disease on work ability.
  
  
  
  To assess sick leave (short-term absence) and disability pension (long-term absence) before and after diagnosis of MS.
  
  
  
  Patients with MS in Sweden were identified in a nationwide disease-specific register and matched with general population controls. Sick leave and disability pension were measured before and after index (i.e. the MS diagnosis date).
  
  
  
  The final sample comprised 6092 patients and 60,345 controls (mean age 39 years; 70% female). The mean annual prevalence of sick leave ranged from 12% the first year after index to 23% after 11 years among patients and from 13% to 13% among controls. Corresponding estimates for disability pension were 12% and 55% for patients and 7% and 9% for controls. Significant differences in sick leave were observed up to 15 years before index and 3 years for disability pension.
  
  
  
  Patients with MS in Sweden have elevated levels of sick leave and disability pension up to 15 years before disease diagnosis. Our results highlight the burden of disease on affected patients and society and underscore the substantial unmet medical need.
authors.affiliation: Mapi Group, Stockholm, Sweden/Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden erik.landfeldt@ki.se.
authors.forename: Erik
authors.initials: E
authors.lastname: Landfeldt
authors.affiliation: Mapi Group, Stockholm, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Castelo-Branco
authors.affiliation: Mapi Group, Stockholm, Sweden.
authors.forename: Axel
authors.initials: A
authors.lastname: Svedbom
authors.affiliation: Novartis, Stockholm, Sweden.
authors.forename: Emil
authors.initials: E
authors.lastname: Löfroth
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Andrius
authors.initials: A
authors.lastname: Kavaliunas
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Hillert
mesh_terms: D000041:Absenteeism; D000328:Adult; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000191:economics / Q000453:epidemiology*; D010415:Pensions / Q000706:statistics & numerical data*; D062706:Prodromal Symptoms; D012042:Registries / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology
keywords: Multiple sclerosis; absenteeism; disability pension; longitudinal studies; sick leave; social insurance