Thyroid and Old Age

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Thyroid status, disability and cognitive function, and survival in old age.

Gussekloo J, van Exel E, de Craen AJ, Meinders AE, Frolich M, Westendorp RG.

http://www.ncbi.nlm.nih.gov/entrez/query

fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15572717

Section of Gerontology and Geriatrics, Department of General Internal

Medicine, Leiden University Medical Center, Leiden, The Netherlands.

jgussekloo@...

CONTEXT: Despite the equivocal outcomes of randomized controlled trials,

general clinical opinion favors screening and treatment of elderly

individuals with subclinical thyroid disorders. OBJECTIVES: To determine

whether subclinical thyroid dysfunction should be treated in old age and the

long-term impact of thyroid dysfunction on performance and survival in old

age. DESIGN, SETTING, AND PARTICIPANTS: A prospective, observational,

population-based follow-up study within the Leiden 85-Plus Study of 87% of a

2-year birth cohort (1912-1914) in the municipality of Leiden, the

Netherlands. A total of 599 participants were followed up from age 85 years

through age 89 years (mean [sD] follow-up, 3.7 [1.4] years). MAIN OUTCOME

MEASURES: Complete thyroid status at baseline; disability in daily life,

depressive symptoms, cognitive function, and mortality from age 85 years

through 89 years. RESULTS: Plasma levels of thyrotropin and free thyroxine

were not associated with disability in daily life, depressive symptoms, and

cognitive impairment at baseline or during follow-up. Increasing levels of

thyrotropin were associated with a lower mortality rate that remained after

adjustments were made for baseline disability and health status. The hazard

ratio (HR) for mortality per SD increase of 2.71 mIU/L of thyrotropin was 0

77 (95% confidence interval [CI], 0.63-0.94; P = .009). The HR for mortality

per SD increase of 0.21 ng/dL (2.67 pmol/L) of free thyroxine increased 1

16-fold (95% CI, 1.04-1.30; P = .009). CONCLUSIONS: In the general

population of the oldest old, elderly individuals with abnormally high

levels of thyrotropin do not experience adverse effects and may have a

prolonged life span. However, evidence for not treating elderly individuals

can only come from a well-designed, randomized placebo-controlled clinical

trial.

PMID: 15572717 [PubMed - indexed for MEDLINE]

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Thyroid-Adrenal Connection: Information and Resources

http://www.bestweb.net/~om/thyroid

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