Background Patients with HD exhibit cognitive and emotional changes in addition to movement symptoms. Multiple factors are therefore likely to affect patients' quality of life.

Aims We aimed to investigate relationships between cognitive and emotional factors and self-reported quality of life in Huntington's disease.

Methods Participants were 16 outpatients with Huntington's disease (mean age 53 years, SD=7.5, range=42–61; mean education 13 years, SD=2.6, range 11–17; mean years since motor onset 6.3 years, SD=5.5, range 2–18), recruited from the Queen Elizabeth Psychiatric Hospital, Birmingham, UK. Quality of Life (QoL) was measured using the SF36. We administered a range of executive tasks (including measures of verbal fluency, working memory and inhibition), and the frontal systems behaviour scale to assess apathy, disinhibition and executive dysfunction. The Interpersonal Reactivity Index was used to assess aspects of empathy and perspective taking, and the Unified Huntington's Disease Rating Scale motor assessment was carried out.

Results QoL scores were not related to motor symptom scores, or scores on specific executive tasks. However, QoL was lower for patients who exhibited greater apathy and showed more evidence of executive dysfunction in their everyday behaviour. Of additional interest, we found that disinhibited behaviour was associated with reduced empathic concern.

Conclusions Deterioration in mood and cognitive function can impact perceived QoL more than movement disorder in HD. Understanding more about the interactions between cognitive, emotional and behavioural changes in HD will be critical in the development and evaluation of future interventions.