Neuropsychological Features Of Patients With Primary Hypothyroidism In The Ecologically Unfavorable Region Of The Pre-Aral Area

Abstract

Primary hypothyroidism is associated not only with endocrine dysfunction but also with cognitive, emotional, and affective disorders that may significantly reduce patients’ quality of life. This study aimed to assess the neuropsychological characteristics of patients with primary hypothyroidism living in the ecologically unfavorable region of the Pre-Aral Area. The research was conducted at the Khorezm Regional Multidisciplinary Medical Center during 2023–2025 and included 143 participants divided into four groups: patients with primary hypothyroidism and neurological complications living in the Pre-Aral Area, patients with primary hypothyroidism without neurological complications living in the same region, patients with primary hypothyroidism living outside ecologically unfavorable territories, and practically healthy controls. Neuropsychological assessment was performed using the MoCA, MMSE, HADS, and SF-36 scales. The most pronounced cognitive impairment was observed in patients with primary hypothyroidism and neurological complications from the Pre-Aral Area, with lower MoCA and MMSE scores compared with other groups. These patients also demonstrated higher levels of anxiety and depressive symptoms according to HADS and a marked decrease in both physical and mental components of quality of life according to SF-36. The findings indicate that the combination of thyroid insufficiency, neurological complications, and unfavorable environmental conditions may aggravate cognitive and emotional disturbances. The results support the inclusion of MoCA/MMSE and HADS in early screening algorithms for patients with primary hypothyroidism, especially among residents of the Pre-Aral Area.