Objective: To evaluate cognitive performance in patients with chronic postoperative hypoparathyroidism and to investigate its association with biochemical parameters.

Methods: This prospective, observational, cross-sectional study included 56 patients aged 40–65 years with chronic postoperative hypoparathyroidism, 28 post-thyroidectomy hypothyroid patients without hypoparathyroidism, and 28 healthy controls. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). Biochemical parameters, including albumin-corrected serum calcium and intact parathyroid hormone (iPTH), were measured concurrently. Multivariable analyses were performed to identify independent determinants of cognitive performance.

Results: Although no significant differences were observed among the groups in terms of total MMSE scores, selective differences were detected in the registration and language subdomains in patients with chronic postoperative hypoparathyroidism. Albumin-corrected serum calcium levels and age independently predicted language performance. In addition, a positive correlation was identified between iPTH levels and registration memory scores.

Conclusion: Chronic postoperative hypoparathyroidism may be associated with mild, domain-specific cognitive alterations rather than global cognitive decline. The association of albumin-corrected serum calcium and age with language performance suggests a potential role of calcium homeostasis in cognitive function. Cognitive assessment may therefore be considered as part of long-term follow-up in these patients.

Keywords: hypoparathyroidism, calcium, mini-mental state examination, cognition