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ReviewAnnales d'endocrinologie · 2026

Decision-making in primary hyperparathyroidism in older patients: surgical or conservative management?

Nathanaël Bassas Letissier, Evelyne Liuu, Gianluca Donatini … Helena Mosbah

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GeriatricsReview

Primary hyperparathyroidism affects 1.5% of adults over 65 years old.

Decision-making in primary hyperparathyroidism in older patients: surgical or conservative management?

Nathanaël Bassas Letissier et al. · Annales d'endocrinologie · 2026

1.5%

Results

the percentage of adults over 65 with overactive parathyroid glands

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While management is well codified before the age of 50, with surgery being preferred, recommendations for older individuals are less clear.

However, this indication must be weighed against the patient's co-morbidities, frailty and wishes.

Drug-based alternatives are a valid option for patients unable or unwilling to undergo surgery.

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The fundamental question, however, is to evaluate the suitability of one treatment over another, depending on the patient's phenotype.

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Conclusion

The present article firstly describes the clinical and biological specificities of PHPT in older adults, secondly compares the therapeutic strategies available, and thirdly identifies geriatric markers to guide the therapeutic decision.

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Decision-making in primary hyperparathyroidism in older patients: surgical or conservative management?

Primary hyperparathyroidism affects 1.5% of adults over 65 years old.

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