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

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.