Cognitive function in hypothyroid patients: a tertiary care-based cross-sectional study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20242943Keywords:
Cognitive function, Cognitive impairment, Hypothyroidism, ThyroidAbstract
Background: Estimation of cognitive impairment among hypothyroid individuals plays an important role in intervening in the disease progress at the earliest. The present study was conducted to measure the cognitive impairment in a hypothyroid state.
Methods: A cross-sectional study was conducted among 260 sample of hypothyroid patients at Agartala Government Medical College Hospital from January to June 2024 using a case record form where pregnant state, acute illnesses, and co-morbidities were excluded. The General Practitioner Assessment of Cognition scale was used to measure the cognitive impairment. Both descriptive and inferential statistics were used using SPSS vs 21.0.
Results: Out of 260 cases of hypothyroidism, 32.7% have cognitive impairment. Only 16.9% of the subjects with sub-clinical states showed cognitive impairment but 58% of them with visible clinical manifestations showed cognitive impairment (p-value .001). The cognitive function was more impaired among males (51.8%) than females (28.0%) which is found to be statistically significant (p-value .004).
Conclusions: The study concluded that every third person had cognitive impairment among hypothyroid patients. Clinical hypothyroidism, advance age, and males were associated with cognitive impairment. Newly diagnosed cases were found to show increased impairment.
References
Anandkumar S, Venkatesh S. Clinical assessment of cognitive impairment in various conditions of hypothyroidism patients. World J Pharm Res. 2019;8(7):1545-55.
Samuels MH. Psychiatric and cognitive manifestations of hypothyroidism. Curr Opin Endocrinol Diabetes Obes. 2014;21(5):377-83.
Bagcchi S. Hypothyroidism in India: more to be done. Lancet Diabetes Endocrinol. 2014;2(10):778.
Smith CD, Grondin R, LeMaster W, Martin B, Gold BT, Ain KB. Reversible cognitive, motor, and driving impairments in severe hypothyroidism. Thyroid. 2015;25(1):28-36.
Bronas UG, Puzantian H, Hannan M. Cognitive Impairment in Chronic Kidney Disease: Vascular milieu and the potential therapeutic role of exercise. Biomed Res Int. 2017;2017:1-10.
Steckl C, Staats N. Various causes of cognitive disorders. 2017. Available at: https://www.mentalhelp.net/cognitive-disorders/various-causes/. Accessed on 20th July 2024.
Parsaik AK, Singh B, Roberts RO, Pankratz S, Edwards KK, Geda YE, et al. Hypothyroidism and risk of mild cognitive impairment in elderly persons a population-based study. JAMA Neurol. 2014;71(2):201–7.
Osterweil D, Syndulko K, Cohen SN, Pettler-Jennings PD, Hershman JM, Cummings JL, et al. Cognitive function in non-demented older adults with hypothyroidism. J Am Geriatr Soc. 1992;40(4):325-35.
Bajaj S, Sachan S, Misra V, Varma A, Saxena P. Cognitive function in subclinical hypothyroidism in the elderly. Indian J Endocrinol Metab. 2014;18(6):811.
Mulat B, Ambelu A, Yitayih S, Gela YY, Adera A, Yeshaw Y, et al. Cognitive Impairment and Associated Factors Among Adult Hypothyroid Patients in Referral Hospitals, Amhara Region, Ethiopia: Multicenter Cross-Sectional Study. Neuropsychiatric Disease and Treatment. 2021;17:935–43.
Brodaty H, Connors MH, Loy C, Teixeira-Pinto A, Stocks N, Gunn J, Mate KE, Pond CD. Screening for Dementia in Primary Care: A Comparison of the GPCOG and the MMSE. Dement Geriatr Cogn Disord. 2016;42(5-6):323-30.
Roy S, Sarathi P, Das A, Debnath T. Prevalence of Hypothyroidism among the patients attended in the clinics of Tripura Medical College and Dr. B. R. A. M. Teaching Hospital, Agartala, Tripura. Indian Journal of Applied Research. 2016;6(3):498-500.
Hu Y, Wang Z, Guo Q, Cheng W, Chen Y. Is thyroid status associated with cognitive impairment in elderly patients in China? BMC Endocr Disord. 2016:16:11.
Brodaty H, Pond D, Kemp NM, Luscombe G, Harding L, Berman K, et al. The GPCOG: a new screening test for dementia designed for general practice. J Am Geriatr Soc. 2002;50(3):530-4.
Ye Y, Wang Y, Li S, Guo J, Ding L, Liu M. Association of hypothyroidism and the risk of cognitive dysfunction: a meta-analysis J. Clin. Med. 2022;11(22):6726.
Ettleson MD, Raine A, Batistuzzo A, Batista SP, McAninch E, Teixeira MC, et al. Brain Fog in Hypothyroidism: Understanding the Patient’s Perspective Endocr Pract. 2022;28(3):257–64.
Nielsen-Bohlman L, Panzer AM, Kindig DA. Institute of Medicine (US) committee on health literacy; prescription to end confusion; 2004. Available at: https://www.ncbi.nlm.nih.gov/books/ NBK216033. Accessed on 16th July 2024.
Davis JD, Tremont G. Neuropsychiatric aspects of hypothyroidism and treatment reversibility. Minerva Endocrinol. 2007;32:49–65.
Constant EL, Adam S, Seron X. Anxiety and depression, attention, and executive functions in hypothyroidism. J Int Neuropsychol Soc. 2005;11:535-44.
Engum A, Bjaro T, Mykletun A. An association between depression, anxiety and thyroid function-a clinical fact or an artefact? Acta Psychiatr Scand. 2002;106:27-34.
Correia N, Mullally S, Cooke G. Evidence for a specific defect in hippocampal memory in overt and subclinical hypothyroidism. J Clin Endocrinol Metab. 2009;94:3789-97.
Cooke GE, Mullaly S, Correia N. Hippocampal volume is decreased in adults with hypothyroidism. Thyroid. 2014;24:1-8.
Bauer M, Silverman DH, Schlagenhauf F. Brain glucose metabolism in hypothyroidism: a positron emission tomography study before and after thyroid hormone replacement therapy. J Clin Endocrinol Metab. 2009;94:2922-9.
Lass P, Slawek J, Derejko M. Neurological and psychiatric disorders in thyroid dysfunctions. The role of nuclear medicine: SPECT and PET imaging. Minerva Endocrinol. 2008;33:75–84.
Constant EL, de Volder AG, Ivanoiu A. Cerebral blood flow and glucose metabolism in hypothyroidism: a positron emission tomography study. J Clin Endocrinol Metab. 2001;86:3864–70.
He XS, Ma N, Pan ZL. Functional magnetic resource imaging assessment of altered brain function in hypothyroidism during working memory processing. Eur J Endocrinol. 2011;164:951-9.
Osterweil D, Syndulko K, Cohen SN. Cognitive function in non-demented older adults with hypothyroidism. J Am Geriatr Soc. 1992;40(4):325–35.
Bégin ME, Langlois MF, Lorrain D, Cunnane SC. Thyroid function and cognition during aging. Curr Gerontol Geriatr Res. 2008;(1):1–11.
Murman DL. The impact of age on cognition. Semin Hear. 2015;36(3):111-21.
Dugbartey AT. Neurocognitive aspects of hypothyroidism. Arch Intern Med. 1998;158(13):1413-8.
Bono G, Fancellu R, Blandini F, Santoro G, Mauri M. Cognitive and affective status in mild hypothyroidism and interactions with L-thyroxine treatment. Acta Neurol Scand. 2004;110(1):59-66.
