The impact of age on quality of life and frailty outcomes after parathyroidectomy in patients with primary hyperparathyroidism

Objective Parathyroidectomy (PTx) improves quality of life (QoL) in patients with primary hyperparathyroidism (PHPT). Whether this effect is modified according to the patients' age is unknown. The aim of this study was to evaluate the impact of age on the effect of PTx on QoL and frailty in patients with PHPT, six months post-PTx. Methods This was a prospective cohort study, including patients with PHPT, admitted from January 2016 to December 2019, divided into two categories: younger (<= 65 years old) and older (> 65 years old). QoL was assessed with the Pasieka questionnaire (PAS-Q) two days pre- and six months post-operatively. Frailty was also assessed at the same time intervals, with the Frailty Index (FI). Results One hundred and thirty-four patients (younger group: 96 patients, mean age 50.4 +/- 9.8 years; older group: 38 patients, mean age 72.1 +/- 4.9 years) were included. PTx resulted in a significant reduction in PAS-Q score in both groups. Notably, a greater reduction in "mood swings", "irritability", "itchy skin" and "feeling thirsty" PAS-Q domains was observed in the younger group. In contrast, a greater decrease in "bone pain", "tiredness", "weakness", "joint pain", "getting off chair" and "headaches" items was observed in the older group. Moreover, PTx led to a decrease in FI only in this group. Conclusions PTx leads to an improvement in QoL both in older (> 65 years) and younger (<= 65 years) patients with PHPT, attributed to a differential effect on PAS-Q items. Frailty improves only in the older group.