Abstract
PURPOSE: Previous research has documented cognitive deficits in survivors of papillary thyroid carcinoma (PTC).Our longitudinal study with large sample size, aims to assess the impact of menopausal status on cognitive function, elucidate related factors of cognitive impairment, and chart the trajectory of cognitive changes over time in female PTC patients. METHODS: In this longitudinal study, we administered the Montreal Cognitive Assessment (MoCA) to 322 female PTC patients over 40 years old, before surgery and at 3 and 6 months after surgery. Propensity score matching (PSM) was used to adjust for baseline disparities, leading to a final analysis of 228 patients (114 premenopausal and 114 postmenopausal). Cognitive scores were compared between groups using the Mann-Whitney U test, and univariate and multivariate logistic regression analyses were performed to identify independent predictors of cognitive impairment. RESULTS: Postmenopausal women demonstrated a significantly higher susceptibility to impairment in delayed recall (p = 0.004) and global cognition (p = 0.006) when compared with premenopausal women. Multivariate analysis identified menopause (p < 0.001) and rural residence (p = 0.001) as independent risk factors for cognitive impairment. Furthermore, a gradual improvement in cognitive function over time was observed across both groups over the course of the study. CONCLUSIONS: In female PTC patients, postmenopausal status and rural residence are significant risk factors for cognitive impairment. Postmenopausal women are more susceptible to cognitive deficits than premenopausal women in delayed recall and global cognition.Although cognitive function improves over time, it is crucial for physicians to closely monitor and support these patients to optimize their prognosis.