How does work disability of patients with MS develop before and after diagnosis? A nationwide cohort study with a reference group

Objectives 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. Design Population-based cohort study. Setting The adult Swedish general population. Participants Residents aged 24–57 diagnosed with MS (n=3685) in 2003–2006 and 18？425 matched controls without MS. Primary and secondary outcome measures 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. Results 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. Conclusions 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