The Quality of Life and Psychological, Social and Cognitive Functioning of Patients with Acromegaly (original) (raw)
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Frontiers in endocrinology, 2018
Acromegalic patients display a distinct neuropsychological profile and suffer from chronic physical complaints. We aimed to investigate in more detail these aspects in acromegalic patients, dependent on influencing factors like disease activity, age, sex, chronic medication, surgery, pituitary radiation, pituitary insufficiency and comorbidities. Cross sectional, multicentric. 129 patients (M/W 65/64, 58.3 ± 12.7 years, 53/76 with active/controlled disease). Acromegalic patients completed the following inventories: NEO-FFI, IIP-D, and the Giessen Complaints List (GBB-24), after written informed consent. Age, sex, IGF-1 concentrations, comorbidities, treatment modalities and pituitary insufficiency were documented. Acromegalic patients or specific patient-subgroups were more agreeable, neurotic, exploitable/permissive, introverted/socially avoidant, non-assertive/insecure, nurturant and less open to experience, cold/denying, domineering, compared to normal values from the healthy pop...
Executive functioning and quality of life in acromegaly
Psychology Research and Behavior Management
Introduction: Active acromegaly is a rare chronic endocrine disorder caused by excessive growth hormone (GH). Clinical studies suggest that cognitive performance is impaired in acromegaly-particularly executive function as well as short-and long-term memory. This study compared the quality of life (QoL) and executive functioning in acromegaly patients vs healthy controls. Materials and methods: This was an observational case-control study on 38 subjects divided into 19 acromegaly patients and 19 matched controls. The groups were evaluated for QoL, attention, and executive function. All subjects completed Acromegaly Quality of Life Questionnaire (AcroQoL), Trail Making Test (parts A and B), Stroop, and phonemic fluency tests. Results: Acromegaly patients had an AcroQoL global score that was significantly lower than controls. There were significant differences between the acromegaly group and the control group in terms of the physical effects (P=0.001) and appearance (P<0.001) but not for personal relationships (P=0.421). Acromegaly patients performed worse in the trail making test part B. They provided significantly fewer words than healthy subjects in phonemic fluency testing. Although patients performed generally worse than controls, no significant differences were noted in the trail making test part A, Stroop test, and the constrained phonemic fluency. Conclusion: Acromegaly patients display worse executive functioning than healthy controls and have a decreased QoL.
Predictors of Quality of Life in Acromegaly: No Consensus on Biochemical Parameters
Frontiers in Endocrinology, 2017
Background: Quality of life (QoL) in patients with acromegaly is reduced irrespective of disease state. The contributions of multifactorial determinants of QoL in several disease stages are presently not well known. Objective: To systematically review predictors of QoL in acromegalic patients. Methods: Main databases were systematically searched using predefined search terms for potentially relevant articles up to January 2017. Inclusion criteria included separate acromegaly cohort, non-hereditary acromegaly, QoL as study parameter with clearly described method of measurement and quantitative results, N ≥ 10 patients, article in English and adult patients only. Data extraction was performed by two independent reviewers; studies were included using the PRISMA flow diagram. Results: We identified 1,162 studies; 51 studies met the inclusion criteria: 31 cross-sectional observational studies [mean AcroQoL score 62.7 (range 46.6-87.0, n = 1,597)], 9 had a longitudinal component [mean baseline AcroQoL score 61.4 (range 54.3-69.0, n = 386)], and 15 were intervention studies [mean baseline AcroQoL score 58.6 (range 52.2-75.3, n = 521)]. Disease-activity reflected by biochemical control measures yielded mixed, and therefore inconclusive results with respect to their effect on QoL. Addition of pegvisomant to somatostatin analogs and start of lanreotide autogel resulted in improvement in QoL. Data from intervention studies on other treatment modalities were too limited to draw conclusions on the effects of these modalities on QoL. Interestingly, higher BMI and greater degree of depression showed consistently negative associations with QoL. Hypopituitarism was not significantly correlated with QoL in acromegaly. Conclusion: At present, there is insufficient published data to support that biochemical control, or treatment of acromegaly in general, is associated with improved QoL. Studies with somatostatin receptor ligand treatment, i.e., particularly lanreotide autogel 2 Geraedts et al.
The impact of biochemical control on the quality of life of patients with acromegaly
BULLETIN OF INTEGRATIVE PSYCHIATRY
Purpose: Quality of life (Qol) is undoubtedly important for patient case management. The current goal of a treatment extends therefore beyond biochemical monitoring, including the physical, mental and social state of wellbeing. We aimed to correlate disease activity with the perception of Qol in acromegalic patients. Methods: We performed a single center cross-sectional study on 26 patients: 9 men (34.6%) and 17 women (65.4%), with a mean age of 53 ± 11.5 years. Eleven patients (42.3%) had a biochemically controlled disease, while 15 subjects (57.7%) had an active disease. Results: The mean total score of the quality of life was 60.9 ± 12.6 in women, ranging from 40 to 85, while for men, the mean total score was of 64.04 ± 14.78, ranging from 42 to 85 (p=0.575). There was no significant difference between the mean AcroQol scores of patients with controlled or active disease (62.54 ± 13.42 vs 61.23 ± 13.46, p = 0.804). Patients younger than 60 had a significantly lower total score compared to older patients, (58.36 ± 14.17 vs 64.26 ± 12.44, p=0.047). Rural residents also scored lower than patients belonging to the urban region: (58.18 ± 11.21 vs 67.19 ± 14.39, p=0.048). Disease duration was negatively correlated with total score on AcroQol (r =-0.253, p= 0.045). We did not find significant correlations between GH and IGF1 levels and AcroQol (p=0,622 and p = 0.844, respectively). Conclusions: We found no significant differences between males and females, as well as between patients with active and controlled disease regarding the Qol, but other factors like 72/Bulletin of Integrative Psychiatry New Series December 2019 Year XXV No. 4 (83) age or locality provenience may play some role for the perceived health status and quality of life in acromegalic patients
Endocrine, 2022
Purpose Current treatment of acromegaly restores a normal life expectancy in most cases. So, the study of persistent complications affecting patients' quality of life (QoL) is of paramount importance, especially motor disability and depression. In a large cohort of acromegalic patients we aimed at establishing the prevalence of depression, to look for clinical and sociodemographic factors associated with it, and to investigate the respective roles (and interactions) of depression and arthropathy in influencing QoL. Methods One hundred and seventy-one acromegalic patients (95 women and 76 men, aged 20-85 years) among those recruited in a cross-sectional Italian multicentric study were investigated. Each patient filled in three validated questionnaires: AcroQoL, WOMAC (measuring articular pain, stiffness and functionality), and AIMS (evaluating articular symptoms and depression). Results A very high (up to 28%) depression rate was detected in acromegalic subjects. Two patients showing pathological AIMS depression scores, committed suicide during the three years observational period. In our population poor psychological status was significantly associated with female sex. Furthermore, a significant strong correlation was found between AIMS depression score and WOMAC score. Both depression and arthropathy-related motor disability turned out to independently contribute with similar strength to the impairment of QoL. Conclusions We report a high prevalence of depression in acromegaly, which is associated with female sex and arthropathy. Both depression and arthropathy strongly and independently contribute to the impaired QoL of patients. Our study shows that assessment and monitoring of psychological status is mandatory in acromegaly, also suggesting an inexpensive tool for this assessment.
Journal of Clinical …, 2005
Acromegaly Quality of Life Questionnaire (AcroQoL) is a new disease-generated quality of life (QOL) questionnaire comprising 22 questions covering physical and psychological aspects of acromegaly and subdivided into "appearance" and "personal relations" categories. We have performed a cross-sectional study of QOL in 80 patients [43 male (mean age, 54.2 yr; range, 20-84); median GH, 0.93ng/ml (range, Ͻ0.3 to 23.7); IGF-I, 333.1 ng/ml (range, 47.7-899)] with acromegaly. In addition to AcroQoL, patients completed three generic QOL questionnaires: Psychological General Well-Being Schedule (PGWBS), EuroQol, and a signs and symptoms score (SSS). All three generic questionnaires confirmed impairment in QOL [mean scores: PGWBS, 69.6; EuroQol, visual analog scale, 66.4 (range, 20-100) and utility index, 0.7 (range, Ϫ0.07 to 0.92); and SSS, 12 (range, 0-27)]. There was no correlation between biochemical control and any measure of QOL. AcroQoL (57.3%; range, 18.2-93.2) correlated with PGWBS (r ϭ 0.73; P Ͻ 0.0001); and in patients with active disease, AcroQoL-physical dimension correlated with SSS (r ϭ Ϫ0.67; P Ͻ 0.0003). In all questionnaires, prior radiotherapy was associated with impaired QOL. In conclusion, these data underline the marked impact that acromegaly has on patients' QOL and provide the first evidence validating AcroQoL against well-authenticated measures of QOL. This indicates the potential of AcroQoL as a patient-friendly measure of disease activity.