Which features of Parkinson's disease predict earlier exit from the workforce?

Introduction: Few objective data exist regarding predictors of leaving the workforce (LWF) in Parkinson's disease (PD). Methods: Employed PD patients were followed prospectively. Baseline demographics, disease duration, and measures of disease severity, cognition, disability, and mental health were compared between patients working at last follow-up versus those who left the workforce using student's t-tests and multivariate analyses controlling for age, gender, and PD duration. Results: Of 419 employed patients, 224 had left the workforce by last follow-up. Patients who left the workforce were more likely to be older, female, have lower-income, and have longer PD duration. LWF patients had greater baseline depression, anxiety, and overall psychiatric distress. PD severity did not differ between groups. Conclusion: Demographics, disease duration, and mental health contribute to LWF, but not motor severity. Age, gender and income contributions are difficult to modify but important to recognize. Worse baseline mental health is associated with LWF, suggesting a potential target for intervention. (C) 2014 Elsevier Ltd. All rights reserved.