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Cognitive dysfunction in patients with primary adrenal insufficiency: A systematic review

Ana M Ramos-Leví1, Emma Cañada1, Jordi A Matias-Guiu2

  • 1Department of Endocrinology, Hospital Universitario La Princesa, Instituto de Investigación Princesa, Universidad Autónoma, Madrid, Spain.

Applied Neuropsychology. Adult
|June 29, 2022
PubMed

Insights

Patients with Addison's disease (AD) show impaired verbal learning and episodic memory. This cognitive impairment in AD may stem from factors like hypocortisolism and sleep disturbances, suggesting a multifactorial cause.

Area of Science:

  • Endocrinology
  • Neuroscience
  • Psychology

Background:

  • Addison's disease (AD) is characterized by insufficient glucocorticoid and mineralocorticoid production.
  • While fatigue and reduced quality of life are common in AD, cognitive effects remain under-explored.

Purpose of the Study:

  • To systematically review existing literature on cognitive impairment in Addison's disease.
  • To investigate the influence of treatment regimens on cognitive function in AD patients.

Main Methods:

  • Systematic review of 10 articles meeting inclusion criteria, assessing intermediate quality.
  • Analysis of studies examining AD's impact on cognition, treatment effects, sleep quality, and potential mechanisms like neuroglycopenia.

Main Results:

  • Episodic memory was the most frequently impaired cognitive domain in AD patients compared to controls.
  • Moderate reductions in verbal learning performance were observed in patients with AD.
  • Potential contributing factors include hypocortisolism-induced neuroglycopenia and impaired sleep quality.

Conclusions:

  • Patients with Addison's disease exhibit moderately reduced verbal learning performance.
  • The pathophysiology of cognitive impairment in AD is likely multifactorial.
  • Future research requires larger sample sizes, comprehensive neuropsychological assessments, and neuroimaging.
Keywords:
Addison’s diseaseadrenal insufficiencycognitive dysfunctionglucocorticoidsneurocognitive

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