Alejandra Machado

Alejandra Machado

Research Specialist
Visiting address: Avd försäkringsmedicin, Karolinska Institutet, 17177 Stockholm
Postal address: K8 Klinisk neurovetenskap, K8 Fm Friberg, 171 77 Stockholm

About me

  • My previous research work focused on cognitive changes in the context of normal aging and neurodegenerative disorders such as Alzheimer’s Disease (AD), with a focus on a multidimensional and integrative approach, combining demographic variables, cognitive assessments, biomarkers, and neuroimaging data. 

    Since 2020, I have extended my research into the field of insurance medicine, with a particular focus on neurological disorders. My work has primarily focused on identifying risk factors for, and the consequences of, sickness absence in individuals with multiple sclerosis (MS). My current line of research addresses individuals with mild cognitive impairment and early-onset dementia when still of working age, exploring how these conditions affect individuals during their final working years, often leading to premature exit from the labour market. My goal is to better understand the how  cognitive decline contributes to reduced work capacity, increased sickness absence or disability pension, and early retirement, as well as how these outcomes are shaped by the influence of demographic, socioeconomic, clinical and cognitive factors.

Articles

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Grants

  • Mild cognitive impairment and dementia diagnosis in the workplace: demographics, risk factors and strategies to withstand the early workforce exit
    Swedish Research Council for Health Working Life and Welfare
    1 January 2025 - 1 January 2028
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2024 - 31 December 2026
    Research problem and specific questions: The labour market is currently undergoing a substantial transformation. The nature of work and the way it is conceptualized is evolving in unprecedented ways. Work is increasingly becoming more remote, complex, and inter-connected whilst employees are expected to be more autonomous and efficient at work, whilst learning and adapting to the new technologies at the same time. Multiple sclerosis (MS) is the most common neurological disease-causing disability in young adults. In the past 20 years, treatment strategies have become increasingly effective. However, most people with MS (PwMS) experience limitations in respect to their work capacity and many are forced to exit the labour market once the disease progresses and substantial disabilities appear. It is uncertain how the changing dynamics of the labour market are impacting the work of PwMS and whether these changes can differ depending on the labour market attachment and the timing of disease onset and progression. Therefore, this project aims to study the impact of the described labour market changes in relation to individuals with MS and disease progression in light of the recently developed highly effective treatments.  Data and method and Plan for project realisation: Different research strategies will be used: Microdata linked from several Swedish registers including all people of working age diagnosed with MS, about 14 000 individuals and matched population references, will be used to explore factors associated with entering the labour market, remaining in paid work long term, and exiting from the workforce. In the second part, survey information collected from over 4000 responders in 2021, linked to register information will be used. Here we will focus on strategies used in relation to work and further deepen the understanding of how MS has influenced their work life. In the third part, individual and focus group interviews including PwMS and employers will be used to contrast our findings with the experiences of the work-life challenges related to new ways of working in combination with experienced physical or cognitive limitations both from a patient and an employer perspective.  Societal relevance and utilisation: This interdisciplinary project will generate new, relevant, and updated knowledge of working outcomes of PwMS given the transformation of the modern labour market and treatment advances for MS.

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