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[Cognitive deterioration in elderly due to primary hyperparathyroidism--resolved by parathyroidectomy]
M H Emmelot-Vonk1, M M Samson, J A Raymakers
1Universitair Medisch Centrum, afd. Geriatrie, Postbus 85.500, 3805 GA Utrecht. m.h.emmelotvonk@digd.azu.nl
Nederlands Tijdschrift Voor Geneeskunde
|October 30, 2001
Summary
Primary hyperparathyroidism can cause cognitive impairment in elderly patients. Surgical treatment, parathyroidectomy, significantly improved symptoms in three older adults, suggesting its consideration for this age group.
Area of Science:
- Endocrinology
- Geriatric Medicine
- Neurosurgery
Background:
- Primary hyperparathyroidism (PHPT) is a common endocrine disorder.
- Its incidence increases with age, yet diagnosis in the elderly can be challenging due to subtle or atypical symptoms.
- Cognitive impairment is an underrecognized manifestation of PHPT, particularly in older adults.
Observation:
- Three elderly patients (79-84 years) presented with cognitive impairment attributed to PHPT.
- These patients experienced mental changes, fatigue, and muscle weakness, characteristic of PHPT in older individuals.
- Surgical removal of the parathyroid gland (parathyroidectomy) was performed.
Findings:
- Parathyroidectomy resulted in a marked improvement in the cognitive and other symptoms in all three patients.
- This suggests a direct link between hyperparathyroidism and cognitive dysfunction in this population.
- The study highlights the efficacy of surgical intervention for PHPT-induced cognitive impairment.
Implications:
- Parathyroidectomy should be strongly considered for elderly patients with primary hyperparparathyroidism, even with mild or solely mental symptoms.
- Early surgical intervention can lead to significant recovery of cognitive function and quality of life in older adults.
- Increased awareness and screening for PHPT in geriatric populations presenting with cognitive decline are warranted.