Young adult Swedish patients with autoimmune Addison's disease report difficulties with executive functions in daily life despite overall good cognitive performance

• Published in: Psychoneuroendocrinology 2022-06, Vol.140, p.105714-105714, Article 105714
• Main Authors: van't Westeinde, Annelies, Ström, Sara, Hirvikoski, Tatja, Dahlqvist, Per, Wahlberg, Jeanette, Gezelius, Anton, Kämpe, Olle, Bensing, Sophie, Lajic, Svetlana
• Format: Article
• Language: English
• Subjects: Addison Disease; Addison's disease; Adult; Cognition; Executive function; Executive Function - physiology; Female; Glucocorticoids - therapeutic use; Humans; Male; Medicin och hälsovetenskap; Mental Fatigue; Neuropsychological Tests; Sweden; Young Adult
• ISSN: 0306-4530; 1873-3360; 1873-3360
• DOI: 10.1016/j.psyneuen.2022.105714

Sub-optimal replacement of glucocorticoids (GC) in autoimmune Addison’s disease (AAD) may affect cognitive functioning. The present study therefore sought to investigate cognitive performance and self-reported problems with executive functions in a cohort of young adult patients with AAD. 67 patients with AAD (39 females), mean age 32 yrs. (range 19–41), and 80 control participants (43 females), mean age 29 yrs. (range 19–43), completed neuropsychological tests estimating verbal and non-verbal intellectual ability, learning, memory and executive functioning, in addition to self-report scales assessing problems with executive functions, fatigue and symptoms of anxiety and depression. Patients performed within the average range on all cognitive tests compared to population norms. However, female AAD patients reported more problems than controls with both hot (emotion regulation) and cold (cognitive regulation) executive functions in daily life. Moreover, experienced problems with executive functions in both male and female patients were associated with increased mental fatigue and lower GC replacement doses. Despite average performance in neuropsychological tests by both sexes, young adult female patients with AAD experience problems with executive functions in daily life. Coping with mental fatigue and optimization of pharmacotherapy may be important factors to be addressed in order to provide timely support for patients. Future research is needed to further determine other risk factors for experiencing executive function impairments in AAD. •We compared patients with Autoimmune Addison’s disease (AAD) to healthy controls.•Patients did not differ from controls on a range of cognitive tests.•Female patients reported to experience problems with executive function.•Experienced problems correlated with mental fatigue and a lower medication dose.