title: How does work disability of patients with MS develop before and after diagnosis? A nationwide cohort study with a reference group.
abstract: We compared work disability of patients with multiple sclerosis (MS) from 5 years before with 5 years after diagnosis, with that of matched controls, and analysed whether progression in work disability among patients with MS was associated with sociodemography.
  
  
  
  Population-based cohort study.
  
  
  
  The adult Swedish general population.
  
  
  
  Residents aged 24-57 diagnosed with MS (n=3685) in 2003-2006 and 18 425 matched controls without MS.
  
  
  
  Annual net days of sickness absence (SA) and disability pension (DP), used as a proxy for work disability, followed from 5 years before to 5 years after diagnosis (ie, T-5-T+5). For patients with MS, regression was used to identify sociodemographic factors related to progression in work disability.
  
  
  
  Work disability of patients with MS increased gradually between T-5 and T-1 (mean: 46-82 days) followed by a sharp increase (T+1, 142 days), after which only a marginal increase was observed (T+5, 149 days). The matched controls had less work disability, slightly increasing during the period to a maximum of ∼40 days. Men with MS had a sharper increase in work disability before diagnosis. High educational level was associated with less progression in work disability before and around diagnosis.
  
  
  
  Patients with MS had more work disability days also 5 years before diagnosis. Several sociodemographic variables were associated with the absolute level and the progression in SA and DP.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden.|Centre for Person-centred Care (GPCC), and Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Hanna
authors.identifier: 0000-0001-6890-5162
authors.initials: H
authors.lastname: Gyllensten
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden.|Department of Analysis and Prognosis, Swedish Social Insurance Agency, Stockholm, Sweden.
authors.forename: Michael
authors.identifier: 0000-0002-8591-6135
authors.initials: M
authors.lastname: Wiberg
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Hillert
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77 Stockholm, Sweden.|Department of Public Health and Medicine, Red Cross University College, Stockholm, Sweden.
authors.forename: Petter
authors.initials: P
authors.lastname: Tinghög
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology*; D010415:Pensions / Q000706:statistics & numerical data*; D012042:Registries; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D013548:Sweden / Q000453:epidemiology; D014938:Work Capacity Evaluation; D055815:Young Adult
keywords: Disability pension; Insurance medicine; Sick leave; Work disability