An Australian study published recently in the Journal of the International Neuropsychological Society has explored the complex relationship between cognitive ability (thinking and memory process) and employment outcomes in people with MS.

Dr Cynthia Honan from the University of NSW, and Dr Rhonda Brown from the Australian National University in Canberra, received a MS Research Australia Project Grant for this work in 2009.

This grant led to the researchers developing a new measurement tool known as the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ). The MSWDQ allows clinicians and researchers to measure work difficulties in people with MS and make predictions about their risk of withdrawal from work.

Approximately 50% of people with MS are not in paid employment. The impact of unemployment on self-esteem, family life, and quality of life can be significant, and data from the MS Research Australia Economic Impact of Multiple Sclerosis in 2010  report has shown that half of the $1 billion per year economic cost of MS to the Australian community is due to lost productivity.

In collaboration with Dr Jennifer Batchelor from Macquarie University, the researchers have applied the MSWDQ tool to assess employment outcomes in a group of 111 people with MS, and also measured various domains of cognitive ability including attention, short- and long-term memory, processing speed, and more complex skills such as planning and abstract reasoning, as well as looking for any symptoms of depression.

They found that people with higher levels of depression or with more severe cognitive difficulties, such as reduced processing speed or memory problems, were more likely to be unemployed or have reduced work hours since their MS diagnosis. Importantly, they also found that a person’s perception of their own cognitive abilities, regardless of their actual abilities, was strongly associated with reduced working hours.

Another recent study published by researchers from the University of Girona, Spain, has shown preliminary evidence for the efficacy of a cognitive training program for improving performance on several areas of cognition in 43 people with MS.

The researchers developed a cognitive rehabilitation intervention targeted to training skills in memory and recall, attention, processing speed, and complex planning and reasoning.

Published in the Multiple Sclerosis journal, the team found that, over a six-month training period, participants showed consistent improvements in these areas following cognitive training. This study adds further support to the benefits of cognitive rehabilitation for improving functional cognition in people with MS.

Dr Honan’s findings that perceived or actual difficulties with thinking and memory skills can directly impact on employment are concerning, however, the Spanish study suggests a possible solution to this. The benefits of cognitive training could have much more widespread benefits, not only improving general memory and attention, but also increasing work performance and potentially reducing the economic impact of MS on individuals and on broader society. More research is now needed to show that cognitive training can indeed assist people with MS to retain employment.