264 IMPROVING INTELLECT WITH PARATHYROIDECTOMY

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Abstract Background Along with classic clinical symptoms and its negative effects on quality of life, primary hyperparathyroidism (pHPT) can influence cognitive status, as well. The aim of this study was to evaluate the cognitive status of patients with primary hyperparathyroidism before and after parathyroidectomy. Methods During a two-year period, a panel study was conducted at our institution, that included patients scheduled for parathyroidectomy. Basic demographic data of interest and relevant clinical data were collected. Cognitive status was assessed in interviews before surgery, one month, and six months following surgery using a Mini-Mental State Examination (MMSE). Results A total of 101 patients (88 females) with pHPT were included in the study, with an average age of 60.7 years. The average preoperative calcium and PTH levels were 2.98 mmol/L and 305.9 ng/mL, respectively. There was a significant improvement in MMSE score six months after parathyroidectomy (from 27.6 to 28.9, p<0.001). Preoperatively, 9.9% of patients had a pathological MMSE score (≤25), and six months after parathyroidectomy, only one patient had the mild disorder. According to the univariable linear regression analysis, older age, lower level of education, unemployment and higher PTH level preoperatively were risk factors for lower MMSE score. Still, based on the multivariable linear regression analysis, only age over 61 was an independent predictor. The risk factor for greater change of MMSE score postoperatively was lower level of education. Conclusions A notable number of patients with primary hyperparathyroidism preoperatively show signs of impaired cognitive status, with substantial improvement after successful parathyroidectomy.

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