This study assessed specific cognitive impairments within a primarily female, hypothyroid population, while controlling for factors that commonly contribute to cognitive decline. Participants (N = 739) included 461 individuals with hypothyroidism. This study involved an online survey assessing several aspects of memory and cognition. Those with hypothyroidism generally scored worse on self-assessments of memory, higher perceived stress, high rates of depression and anxiety, greater fatigue, poorer concentration, and less motivation. A Receiver Operating Characteristic curve indicated that the cognitive questionnaires are successful at classifying hypothyroidism and a mediation analysis showed fatigue is a mediating symptom of these cognitive outcomes.
AghiliRKhamsehMEMalekM, et al. (2012) Changes of subtests of Wechsler memory Scale and cognitive function in subjects with subclinical hypothyroidism following treatment with levothyroxine. Archives of Medical Science8(6): 1096–1101.
AnJHKimYJKimKJ, et al. (2016) L-carnitine supplementation for the management of fatigue in patients with hypothyroidism on levothyroxine treatment: A randomized, double-blind, placebo-controlled trial. Endocrine Journal63(10): 885–895.
4.
BaddelyAHitchG (1974) Working memory. In: BowerGH (ed.) The Psychology of Learning and Motivation. New York, NY: Academic Press, pp.47–89.
5.
BaldiniIMVitaAMauriMC, et al. (1997) Psychopathological and cognitive features in subclinical hypothyroidism. Progress in Neuro-Psychopharmacology & Biological Psychiatry21(6): 925–935.
6.
BathlaMSinghMRelanP (2016) Prevalence of anxiety and depressive symptoms among patients with hypothyroidism. Indian Journal of Endocrinology and Metabolism20(4): 468–474.
7.
BiondiBCappolaARCooperDS (2019) Subclinical hypothyroidism. The Journal of the American Medical Association322(2): 153–160.
8.
Botella-CarreteroJIGalánJMCaballeroC, et al. (2003) Quality of life and psychometric functionality in patients with differentiated thyroid carcinoma. Endocrine-Related Cancer10(4): 601–610.
BroadbentDECooperPFFitzGeraldP, et al. (1982) The cognitive Failures Questionnaire (CFQ) and its correlates. British Journal of Clinical Psychology21(1): 1–16.
11.
BurmeisterLAGanguliMDodgeHH, et al. (2001) Hypothyroidism and cognition: Preliminary evidence for a specific defect in memory. Thyroid11(12): 1177–1185.
12.
CohenSKamarckTMermelsteinR (1983) A global measure of perceived stress. Journal of Health and Social Behavior24(4): 385–396.
13.
CrownS (1949) Notes on an experimental study of intellectual deterioration. British Medical Journal2(4629): 684–695.
14.
DavisJDSternRAFlashmanLA (2003) Cognitive and neuropsychiatric aspects of subclinical hypothyroidism: Significance in the elderly. Current Psychiatry Reports5(5): 384–390.
15.
Eslami-AmirabadiMSajjadiSA (2021) The relation between thyroid dysregulation and impaired cognition/behaviour: An integrative review. Journal of Neuroendocrinology33(3): e12948.
16.
GarberJRCobinRHGharibH, et al. (2012) Clinical practice guidelines for hypothyroidism in adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocrine Practice18(6): 988–1028.
17.
Ghetti FdeFLacerdaRPWernekFZ, et al. (2014) Impairment of muscle vasodilation during mental stress in women with subclinical hypothyroidism. Arquivos Brasileiros de Endocrinologia e Metabologia58(7): 750–757.
18.
GriffithJWKerrWAMayoTB, et al. (1950) Changes in subjective fatigue and readiness for work during the eight-hour shift. Journal of Applied Psychology34(3): 163–166.
19.
HaggertyJjJrEvansDLPrangeAjJr (1986) Organic brain syndrome associated with marginal hypothyroidism. American Journal of Psychiatry143(6): 785–786.
20.
HirschJKSiroisFM (2016) Hope and fatigue in chronic illness: The role of perceived stress. Journal of Health Psychology21: 451–456.
21.
IhleAInauenJScholzU, et al. (2017) Prospective and retrospective memory are differentially related to self-rated omission and commission errors in medication adherence in multimorbidity. Applied Neuropsychology. Adult24(6): 505–511.
22.
KarademasECSimosPZaganasI, et al. (2019) The impact of mild cognitive impairment on the self-regulation process: A comparison study of persons with mild cognitive impairment and cognitively healthy older adults. Journal of Health Psychology24(3): 351–361.
23.
KonerSChaudhuriA (2020) A study of correlation of perceived stress and thyroid function among females in a rural population of reproductive age group. Medical Journal of Dr. D.Y. Patil Vidyapeeth13(1): 30–36.
24.
KroenkeKSpitzerRLWilliamsJB (2001) The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine16(9): 606–613.
25.
MennemeierMGarnerRDHeilmanKM (1993) Memory, mood and measurement in hypothyroidism. Journal of Clinical and Experimental Neuropsychology15(5): 822–831.
26.
MillerKJParsonsTDWhybrowPC, et al. (2007) Verbal memory retrieval deficits associated with untreated hypothyroidism. The Journal of Neuropsychiatry and Clinical Neurosciences19(2): 132–136.
27.
OsorioABallesterosSFayS, et al. (2009) The effect of age on word-stem cued recall: A behavioral and electrophysiological study. Brain Research1289: 56–68.
28.
OsterweilDSyndulkoKCohenSN, et al. (1992) Cognitive function in non-demented older adults with hypothyroidism. Journal of the American Geriatrics Society40(4): 325–335.
29.
PandeyVPSinghTSinghSK (2017) Verbal episodic memory in young hypothyroid patients. Indian Journal of Endocrinology and Metabolism21(6): 812–814.
30.
ParkDCLautenschlagerGHeddenT, et al. (2002) Models of visuospatial and verbal memory across the adult life span. Psychology and Aging17: 299–320.
31.
RazNLindenbergerURodrigueKM, et al. (2005) Regional brain changes in aging healthy adults: General trends, individual differences and modifiers. Cerebral Cortex15(11): 1676–1689.
32.
RyanHH (1947) Imperative need number 8. The bulletin of the national Association of Secondary School Principals31(145): 105–114.
33.
ShieldsGSSazmaMAYonelinasAP (2016) The effects of acute stress on core executive functions: A meta-analysis and comparison with cortisol. Neuroscience and Biobehavioral Reviews68: 651–668.
34.
SmithCDGrondinRLeMasterW, et al. (2015) Reversible cognitive, motor, and driving impairments in severe hypothyroidism. Thyroid25(1): 28–36.
35.
SmithGDella SalaSLogieRH, et al. (2000) Prospective and retrospective memory in normal ageing and dementia: A questionnaire study. Memory8(5): 311–321.
36.
SpitzerRLKroenkeKWilliamsJB, et al. (2006) A brief measure for assessing generalized anxiety disorder: The GAD-7. Archive of Internal Medicine166(10): 1092–1097.
37.
UnnikrishnanAGKalraSSahayRK, et al. (2013) Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian Journal of Endocrinology and Metabolism17(4): 647–652.
38.
van der LindenD (2011) The urge to stop: The cognitive and biological nature of acute mental fatigue. In: AckermanPL (ed.) Cognitive Fatigue: Multidisciplinary Perspectives on Current Research and Future Application. Washington, DC: American Psychological Association, pp.149–164.
39.
VercoulenJHSwaninkCMFennisJF, et al. (1994) Dimensional assessment of chronic fatigue syndrome. Journal of Psychosomatic Research38(5): 383–392.
40.
WekkingEMAppelhofBCFliersE, et al. (2005) Cognitive functioning and well-being in euthyroid patients on thyroxine replacement therapy for primary hypothyroidism. European Journal of Endocrinology153(6): 747–753.
41.
WhybrowPCPrangeAjJrTreadwayCR (1969) Mental changes accompanying thyroid gland dysfunction: A reappraisal using objective psychological measurement. Archives of General Psychiatry20(1): 48–63.
42.
WiseSRossABrownA, et al. (2017) An assessment of fatigue in patients with postural orthostatic tachycardia syndrome. Journal of Health Psychology22(6): 733–742.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
