HYPERCALCEMIA AND NEUROPSYCHIATRIC MANIFESTATIONS IN OLDER ADULTS: EVIDENCE ON A POTENTIALLY REVERSIBLE CAUSE OF COGNITIVE DECLINE

Abstract

This study aimed to analyze, through an integrative literature review, the available evidence on the association between hypercalcemia and neuropsychiatric manifestations in older adults, considering their potential reversibility. The review followed the identification, screening, eligibility, and inclusion stages described in the PRISMA flow diagram. Searches were conducted in the Virtual Health Library (VHL) and PubMed databases between March and December 2025, covering studies published from 2015 to 2025 in Portuguese or English and involving individuals aged 60 years or older. Ten studies were included, predominantly addressing primary hyperparathyroidism and investigating cognitive, affective, psychiatric, and quality-of-life outcomes. The findings indicated associations between alterations in calcium metabolism and manifestations such as depression, anxiety, memory impairment, attention deficits, and cognitive decline. It is concluded that hypercalcemia, particularly when associated with primary hyperparathyroidism, may contribute to neuropsychiatric manifestations in older adults. Some symptoms may improve following treatment of the underlying metabolic condition, highlighting the importance of investigating these alterations, when clinically indicated, in the differential diagnosis of late-onset neuropsychiatric conditions.