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Low work ability and high disability burden in Cushing's syndrome: a multicenter cohort study
Annika Steinkogler1, Stephanie Zopp1, Kathrin Moser1
1Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
Journal of Endocrinological Investigation
|July 8, 2026
Summary
Cushing's syndrome significantly impairs work ability and social function, even after treatment. Structured rehabilitation is crucial for reintegration and improving quality of life for affected individuals.
Area of Science:
- Endocrinology
- Occupational Medicine
- Health Services Research
Background:
- The socio-occupational burden of Cushing's syndrome (CS) is often underestimated.
- Patients in remission may still experience persistent impairments, overlooked in standard clinical practice.
Purpose of the Study:
- To assess work ability, social status, and employment in newly diagnosed and remitted Cushing's syndrome patients.
- To identify factors influencing work capacity and fatigue in CS.
Main Methods:
- A national observational study with two cohorts: prospective evaluation of suspected endogenous glucocorticoid excess (cohort 1) and cross-sectional assessment of remitted CS patients (cohort 2).
- Standardized assessments and validated questionnaires on socioeconomic status, work ability, and fatigue were utilized.
- Cohort 2 compared patients with recovered versus persistent adrenal insufficiency.
Main Results:
- Active CS correlated with lower work ability scores, independently associated with depression.
- In remitted patients, 69% were employed, with 42-58% reporting poor work ability.
- Fatigue negatively correlated with work ability, and illness-related absences and disability recognition were high.
Conclusions:
- Cushing's syndrome imposes a significant socio-occupational burden.
- There is a clear need for structured rehabilitation and reintegration programs for CS patients.
- Addressing persistent impairments and fatigue is essential for improving patient outcomes.
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