Study Finds that Mental Health Issues Lead People with Parkinson's to Leave the Workforce

- Nov 06 2014

Mental health may have greater influence than motor symptoms do on the decision of people with Parkinson’s disease to leave the workforce sooner than they would have preferred. The findings are published in the August 22 online edition of Parkinsonism and Related Disorders.

With an average age of diagnosis of 60 years, more than half of people with PD are of working age at the time of diagnosis. In the early stages of their disease, most people – 94 percent of respondents in one study – say they want to continue working. Yet, there is little data on the emotional, physical, financial and other factors that cause people to leave their jobs.

Researchers led by Melissa Armstrong, M.D., of the University of Maryland followed 419 people with Parkinson’s who received care at the university’s movement disorders center for nearly four years, and who were still employed. The researchers tracked who left the workforce during that time and why.

Results

• Of 419 participants with PD followed in the study, 224 with an average age of 62 had left the workforce by their last follow-up appointment, slightly higher than the average age of 61 for the general US population.
• Of the 224 participants who were no longer working,150 (67 percent) retired, 59 (26 percent) went on disability and 28 (13 percent) left their jobs.
• In comparison with participants who remained employed, those who left the workforce were more likely to be female, older, have a lower income and have lived with PD longer. They also had greater depression, anxiety and overall psychiatric distress and worse mental health-related quality of life, which were present at their first medical visit.
• The working and non-working groups showed no significant differences in race, education, marital status and PD-related medical conditions.

What Does It Mean?

Being able to work is a major concern among people with Parkinson’s disease and is often one of the first questions individuals ask their doctors when diagnosed. Continuing to work enhances the quality of life for people with Parkinson’s who are employed.

Previous studies have showed conflicting results regarding the role of motor symptoms in job performance: one study showed rigidity, tremor and bradykinesiacontributing to inability to work, and another found that tremor and slowness were major challenges at work, but a third study found that cardinal motor symptoms did not predict the need to leave the workforce.

The major finding of this study is that psychiatric features in PD, such as depression and anxiety, were most associated with participants leaving the workforce, while movement symptoms were not. Overall, there is growing awareness that people with PD often have great difficulty with non-motor symptoms of the disease. This emphasizes the importance of addressing mental health in PD.

Further research on how PD affects people's ability to work is needed in order to develop preventive strategies, make therapeutic recommendations, advise people with PD in employment decisions, adapt the workplace to accommodate employees with PD, and develop guidelines for the timing of disability benefits.

Reference: Armstrong MJ, Gruber-Baldini AL, Reich SG, Fishman PS, Lachner C, Shulman LM (2014) Which features of Parkinson’s disease predict earlier exit from the workforce? Parkinsonism and Related Disorders. DOI: 10.1016/j.parkreldis.2014.08.005 http://dx.doi.org/10.1016/j.parkreldis.2014.08.005