Cognitive-motor interaction: relationship with employment status in relapsing-remitting multiple sclerosis
Barbara Eizaguirre1, Natalia Ciufia1, Maria Roman2, Berenice Silva1, Orlando Garcea1, Fernando Caceres2, Ricardo Alonso1, Sandra Vanotti2
1Multiple Sclerosis University Center CUEM, Ramos Mejia Hospital, 2INERE
Objective:

To evaluate the probability of being employed according to CMI performance.

Background:
Multiple Sclerosis(MS) cognitive symptoms can have negative effects on employment status. The identification of these factors will allow mitigating unemployment. Beyond traditional cognitive assessment, impairment in cognitive-motor interaction(CMI) tasks has been reported in persons with MS(PwMS), highlighting its impact on daily activities. 
Design/Methods:

From February 2018 to February 2020, 105 PwMS were recruited. Measuring instruments: Clinical, cognitive and employment status variables were assessed (EDSS, Fatigue severity scale, Beck Depression Inventory, vocational status monitoring tool, BICAMS battery, PASAT, verbal fluency, 7/24 test). CMI: walking while performing two different cognitive tasks: verbal fluency-counting). CMI was evaluated with Dual Task Effect(DTE) calculation ((simple task - double task)/simple task)*100). Parametric and non-parametric statistics were used, significance p <0.05. To evaluate the probability of being employed, a multivariate Probit model was constructed.

Results:
Age: 37.58±11.13 years; Education: 13.51±3.67 years; EDSS: 2.05±1.22; MS duration: 8.51±8.29 years. 57.1% of patients were employed, 26.7% were unemployed and 16.2% belonged to the group of housewives, students and retirees. Verbal fluency and DTE were independent contributors to the probability of being employed, a statistically significant model was created (Chi2=10.37; p=.0056). When calculating the predicted probability of being employed according to the DTE score range, controlling verbal fluency, it was found that the predicted probability of being employed is 78% for a lower DTE score (range=0), and 47 % for a higher score (range=80). 
Conclusions:
A high probability of being employed was found in patients with less cognitive-motor interference. It is important to consider the evaluation of ICM due to its implications for patients.
10.1212/WNL.0000000000203408