Perceived cognitive function in coronary artery disease - An unrecognised predictor of unemployment

Abstract

Objective: We aimed to assess whether perceived cognitive function influences employment and return to work in patients with coronary artery disease (CAD). Design: Prospective longitudinal cohort study. Setting: Health care system of Södertälje, Stockholm County, Sweden. Patients: We included consecutive unselected patients less than 65 years of age with CAD and followed them during 2 years. Main outcome measures: Gainful employment and return to work in patients with CAD. Results: We found that perceived cognitive function predicts both prevalence of unemployment [OR 2.06 (95% CI: 1.36-3.13); p = 0.0006] and early retirement and sick leave due to coronary artery disease [OR 1.59 (95% CI: 1.12-2.25)] both at baseline and 2 years later. Furthermore, perceived cognitive function predicted return to work after an acute coronary event [OR 2.28 (95% CI: 1.08-4.84)]. Covariates such as age, sex, prevalence and degree of angina (CCS grade), cardiovascular risk factors and events did not change the predictive power. Conclusions: Perceived cognitive function is a hitherto unrecognised independent predictor of unemployment, sick leave and return to work in patients with coronary artery disease. Perceived cognitive function adds a new perspective on ability to gainful employment in patients with CAD. The findings might have significance both to individual care and to society. © Springer 2005.