title: Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison's disease.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  Physical activity is decreased in patients with Addison's disease, combined with a reduced subjective health-related QoL and increased fatigue.
authors.affiliation: Department of Internal Medicine, Amphia Hospital, Breda, the Netherlands.
authors.forename: Eline S
authors.initials: ES
authors.lastname: van der Valk
authors.affiliation: Department of Internal Medicine and Endocrinology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Lisanne C C J
authors.initials: LC
authors.lastname: Smans
authors.affiliation: TNO Gezond Leven, Utrecht, the Netherlands.
authors.forename: Hedwig
authors.initials: H
authors.lastname: Hofstetter
authors.affiliation: Amsterdam university of applied sciences and University of the arts, Codarts Rotterdam, Rotterdam, the Netherlands.
authors.forename: Janine H
authors.initials: JH
authors.lastname: Stubbe
authors.affiliation: Department of Internal Medicine and Endocrinology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: de Vries
authors.affiliation: Clinical Sports Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Frank J G
authors.initials: FJ
authors.lastname: Backx
authors.affiliation: Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
authors.forename: Ad R M M
authors.initials: AR
authors.lastname: Hermus
authors.affiliation: Department of Internal Medicine and Endocrinology, University Medical Center, Utrecht, the Netherlands.
authors.forename: Pierre M J
authors.initials: PM
authors.lastname: Zelissen
mesh_terms: D000224:Addison Disease / Q000473:pathology / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D015444:Exercise; D005221:Fatigue / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D005938:Glucocorticoids