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Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease

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Author: Valk, E.S. van der · Smans, L.C.C.J. · Hofstetter, H. · Stubbe, J.H. · Vries, M. de · Backx, F.J.G. · Hermus, A.R.M.M. · Zelissen, P.M.J.
Source:Clinical Endocrinology, 3, 85, 354-360
Identifier: 572355
doi: DOI:10.1111/cen.13059
Keywords: Health · Cortisone acetate · Fludrocortisone · Hydrocortisone · Prasterone · Addison disease · Adrenal insufficiency · Adult · Aged · Cerebrovascular accident · Chronic fatigue syndrome · Comorbidity · Controlled study · Corticosteroid therapy · Cross-sectional study · Disease severity · Dutchman · Educational status · Fatigue · Female · Human · Hypercholesterolemia · Hypertension · Lung disease · Major clinical study · Male · Mental disease · Multiple sclerosis · Musculoskeletal disease · Physical activity · Quality of life · Short Form 36 · Healthy for Life · Healthy Living · Life · CH - Child Health · ELSS - Earth, Life and Social Sciences


Background: Health-related quality of life in patients with Addison's disease has been assessed in various European countries, indicating a reduced quality of life. However, no studies have addressed the impact of Addison's disease on physical activity. Objective: The aim of this study was to investigate the quality of life in Dutch patients with Addison's disease particularly regarding the presence of fatigue and the ability to be physically active. Methods: In this cross-sectional study, a postal survey was performed among Dutch patients with Addison's disease on stable glucocorticoid replacement therapy with hydrocortisone or cortisone acetate. For quality of life and physical activity assessment, patients completed general and health-related quality of life and physical activity questionnaires, and scores were compared to Dutch controls. Results: A total of 328 patients with Addison's disease were studied. In patients with Addison's disease, only 45·7% met the standard of physical activity (Combinorm) compared to 67·8% of Dutch controls (P < 0·01). Forty-eight per cent of patients showed abnormal fatigue, while 61% had severe fatigue. The CIS fatigue scores were significantly higher compared to controls (P < 0·01). We found reduced general subjective health-related QoL scores in both male and female patients, especially in younger patients <65 years of age. Conclusion: Physical activity is decreased in patients with Addison's disease, combined with a reduced subjective health-related QoL and increased fatigue. © 2016 John Wiley & Sons Ltd Chemicals/CAS: cortisone acetate, 50-04-4; fludrocortisone, 127-31-1; hydrocortisone, 50-23-7; prasterone, 53-43-0