Hyperparathyroidism in the Elderly

Abstract

Primary hyperparathyroidism was studied in a well-defined geriatric population of 1129 individuals during a 3-mo. interval. Primary hyperparathyroidism was diagnosed in 1.5%. The diagnosis was based on a morphologic and biochemical basis. From clinical material consisting of 400 patients treated surgically for primary hyperparathyroidism during a 10-yr period, 158 patients (38%) above the age of 64 were studied. At the preoperative evaluation, neuromuscular symptoms were present in 80%, renal insufficiency and kidney stones each occurred in 16%, constipation and/or anorexia in 38%. Ten percent were considered asymptomatic. In 80% the primary hyperparathyroidism was caused by a solitary adenoma. Ninety-four percent became normocalcemic following the operation. Consistent hypocalcemia requiring vitamin D treatment occurred in 3%, and 2% had a persisting hypercalcemia or later recurrence. The therapeutic effect on the neuromuscular symptoms, constipation, anorexia and renal stone formation was considered good or fair in most of the cases. Primary hyperparathyroidism in the elderly occurs with a high prevalence. It can be treated successfully by surgical therapy with a low cost of morbidity, mortality and medical care.