{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T16:47:46Z","timestamp":1775580466632,"version":"3.50.1"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hormones"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Primary hyperparathyroidism (pHPT) is a common endocrine disorder. Often serum calcium is minimally elevated with few symptoms. In elderly patients with multiple co-morbidities, the decision to \u201cwatch and wait\u201d is often most clinically appropriate as operative intervention is associated with high peri-operative risk. We present an elderly patient with mild hypercalcemia secondary to primary hyperparathyroidism. The clinical decision was initially to watch and wait. The patient subsequently developed cognitive impairment and was diagnosed with mixed Alzheimer\u2019s disease\/vascular dementia. She became dependent for all care and housebound. A therapeutic trial of cinacalcet was commenced following a further acute rise in serum calcium. Significant reversal of her functional and cognitive deficit occurred. She was no longer fully dependent. Mini mental state examination (MMSE) improved from 8\/30 to 21\/30. In vulnerable neural systems, even mild elevation in serum calcium may have a profound effect on cognition and function. We propose a therapeutic trial of cinacalcet in such patients.<\/jats:p>","DOI":"10.1007\/s42000-021-00292-4","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T10:43:11Z","timestamp":1619001791000},"page":"587-589","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Cognitive impairment reversed by cinacalcet administration in primary hyperparathyroidism"],"prefix":"10.1007","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3506-359X","authenticated-orcid":false,"given":"J. 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Nat Rev Endocrinol 14(2):115\u2013125. https:\/\/doi.org\/10.1038\/nrendo.2017.104","journal-title":"Nat Rev Endocrinol"},{"issue":"12","key":"292_CR5","doi-asserted-by":"publisher","first-page":"2305","DOI":"10.1210\/js.2019-00316","volume":"3","author":"E Castellano","year":"2019","unstructured":"Castellano E, Attanasio R, Boriano A, Borretta G (2019) Clinical presentation of primary hyperparathyroidism in older adults. J Endocr Soc 3(12):2305\u20132312. https:\/\/doi.org\/10.1210\/js.2019-00316","journal-title":"J EndocrSoc"},{"key":"292_CR6","doi-asserted-by":"publisher","unstructured":"Marcocci C, Bollerslev J, Khan AA, Shoback DM (2014) Medical management of primary hyperparathyroidism: proceedings of the fourth international workshop on the management of asymptomatic primary hyperparathyroidism. J Clin Endocrinol Metab. Vol 99. 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Bailliere Tindall Ltd 333\u2013343. https:\/\/doi.org\/10.1016\/j.beem.2013.02.006","DOI":"10.1016\/j.beem.2013.02.006"}],"container-title":["Hormones"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s42000-021-00292-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s42000-021-00292-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s42000-021-00292-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T02:10:42Z","timestamp":1628734242000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s42000-021-00292-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,21]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["292"],"URL":"https:\/\/doi.org\/10.1007\/s42000-021-00292-4","relation":{},"ISSN":["1109-3099","2520-8721"],"issn-type":[{"value":"1109-3099","type":"print"},{"value":"2520-8721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,21]]},"assertion":[{"value":"17 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Joseph Timmons, Rachel Manners, Matt Bailey, and Claire McDougall confirm that appropriate patient consent was sought for this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}