What Affects the Quality of Life in Autoimmune Addison's Disease?

Introduction: Several studies have shown a reduced quality of life in patients with Addison's disease, but little is known about the potential influences. Methods: We determined the quality of life in 200 patients with Addison's disease using an Addison's disease-specific quality-of-life questionnaire. Data about first symptoms, time to diagnosis and current medication were collected by questionnaires. Results: With increasing latency between first symptoms and diagnosis of adrenal insufficiency, the quality of life decreased in highly significant manner (p < 0.001). Age at manifestation correlated negatively with quality of life (p = 0.01). Significantly lower scores were observed in females versus males (141 vs. 159, p < 0.001). Quality of life decreased significantly with increasing autoimmune comorbidity (p = 0.01). Coeliac disease (p = 0.05), atrophic gastritis (p = 0.01) and primary ovarian failure (p = 0.01) were highly correlated with reduced scores. Conclusions: Quality of life was significantly lower in female patients and in those with manifestation at older ages. With more autoimmune comorbidities, the quality of life scores dropped. The most important factor, however, was latency between first symptoms and diagnosis that affected patients' quality of life even years after manifestation of the disease. These results confirm and extend previous observations and emphasize the importance of a timely diagnosis. Therefore, medical awareness for this rare but easily treatable disorder needs to be sharpened.