Cognitive Impairment and Associated Factors Among Adult Hypothyroid Patients in Referral Hospitals, Amhara Region, Ethiopia: Multicenter Cross-Sectional Study

Background: Cognitive impairment is a common complication of hypothyroidism that affects the patient's quality of life in different aspects. In Ethiopia, though the prevalence of hypothyroidism is high the magnitude of cognitive impairment among these patients is not known. Therefore, the current study is aimed at determining the prevalence of cognitive impairment and associated factors among adult hypothyroid patients. Methods: An institution-based cross-sectional study was employed from February 24 to May 22, 2020, to assess the prevalence of cognitive impairment and associated factors among adult hypothyroid patients. Data was collected by a pretested interviewer administered structured questionnaire and standardized Mini-mental state examination (SMMSE) tool. A cluster sampling technique was used. Data was entered into Epidata version 4.6 and exported into a statistical package for social science (SPSS) version 25 for further analysis. Both bivariable and multivariable logistic regression analyses were done. A 95% confidence interval and P-value <0.05 were used to declare statistical significance. Results: A total of 216 adult hypothyroid patients were included with a response rate of 98.6%. The mean age was 42.5 (+/- 11) years. The prevalence of cognitive impairment was 27.3% (95% CI (21.7, 33.8)) and it was significantly associated with increased age (AOR = 1.23, 95% CI (1.11, 1.34)), increased duration of illness (AOR = 1.48, 95% CI (1.14, 1.90)) and high thyroid-stimulating hormone (TSH) level (AOR = 1.3, 95% CI (1.1, 1.6)). Conclusion: The prevalence of cognitive impairment among hypothyroid patients was high. Increased age, increased duration of illness and high TSH levels were significantly associated with cognitive impairment. Hence, early screening of cognitive impairment among hypothyroid patients with increased age, increased duration of illness and high TSH level should be given due emphasis to increase patients quality of life.