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What Are the Determinants of Leaving the Workforce in Parkinson’s Disease? (S37.005)

2014; Lippincott Williams & Wilkins; Volume: 82; Issue: 10_supplement Linguagem: Inglês

10.1212/wnl.82.10_supplement.s37.005

1526-632X

Melissa J. Armstrong, Ann L. Gruber‐Baldini, Stephen G. Reich, Christian Lachner, Karen Anderson, Paul Fishman, Lisa M. Shulman,

Assistive Technology in Communication and Mobility

Objective: To investigate determinants of leaving the workforce (LWF) in Parkinson’s disease (PD). Background: 50% of PD patients are of employment age at diagnosis; many retire prematurely. Little is known regarding determinants of LWF. Design/Methods: The University of Maryland PD Center systematically enrolls patients in a prospective longitudinal database. For employed patients, baseline demographics and measures of PD severity (UPDRS), psychiatric symptoms (Brief Symptom Inventory-18), cognition (MMSE), HRQoL (SF-12) and disability (Older Americans Resources and Services scale) were compared between patients who were still employed vs. those who LWF by last follow-up. Baseline data were compared using t-tests and proportional hazards models (time to LWF). Results: Of 402 employed patients, 204 (51%) LWF by last follow up. 60% (123) retired, 27% (54) went on disability, and 13% (27) lost their jobs. Average age of LWF was 61.9 (10.6) years. LWF occurred 2.9 (2.0) years after first assessment. Compared to those still employed, LWF patients were older at baseline (58.9 vs. 56.7 years, p=0.02), more likely to be female (31.4% vs. 19.3%, p=0.005), and had lower income (p<0.001). They also had longer PD duration (4.1 vs. 2.7y, p=0.002), greater depression (p=0.01), greater overall psychiatric symptoms (p=0.03), greater disability (0.02), worse cognition (MMSE 29.0 vs. 29.3, p=0.05) and worse physical and mental health QoL (each p=0.01) than those who remained employed. Variables that predicted time to LWF included female gender (p=0.04), longer disease duration (p=0.02), and higher motor and total UPDRS scores (p=0.01 and 0.009, respectively). Conclusions: Disease-specific and non-disease specific factors contribute to LWF in PD. Contributors such as gender and low income are difficult to modify but important to recognize. While motor scores predicted time to LWF, worse depression and slight differences in cognition at baseline were predictive of LWF in general, emphasizing the effect of non-motor features in PD. Disclosure: Dr. Armstrong has received personal compensation for activities with the American Academy of Neurology and the Eli Lilly & Company. Dr. Armstrong has received research support from Abbott. Dr. Gruber-Baldini has nothing to disclose. Dr. Reich has received royalty payments from Movement Disorders: 100 Instructive Cases. Dr. Reich has received research support from NINDS, Chiltern, Synosia, and Phytopharm. Dr. Lachner has nothing to disclose. Dr. Anderson has received personal compensation for activities with Boehringer Ingelheim Pharmaceuticals, Inc. Dr. Anderson has received personal compensation in an editorial capacity for Current Treatment Options in Neurology. Dr. Fischman has received personal compensation for activities with Neura, Pfizer Inc., Forest Laboratories, Inc., Ortho-McNeil, GlaxoSmithKline Inc., BI, Novartis, and Allergan Inc. Dr. Shulman has received personal compensation in an editorial capacity for the AAN Neurology Now patient book series. Dr. Shulman has received research support from the National Institutes of Health, the Michael J Fox Foundation and Teva Neuroscience.