The association between subclinical thyroid dysfunction and dementia: the Health, Aging and Body Composition (Health ABC) Study.

Aubert, Carole E; Bauer, Douglas C; Da Costa, Bruno R; Feller, Martin; Rieben, Carole; Simonsick, Eleanor M; Yaffe, Kristine; Rodondi, Nicolas (2017). The association between subclinical thyroid dysfunction and dementia: the Health, Aging and Body Composition (Health ABC) Study. Clinical endocrinology, 87(5), pp. 617-626. Blackwell Scientific Publications 10.1111/cen.13458

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OBJECTIVE Data on the association between subclinical thyroid dysfunction and dementia are limited and conflicting. We aimed to determine whether subclinical thyroid dysfunction was associated with dementia and cognitive decline. DESIGN Population-based prospective cohort study. PATIENTS Adults aged 70-79 years with measured thyroid function, but no dementia at baseline, and Modified Mini-Mental State (3MS) at baseline and follow-up. MEASUREMENTS Primary outcome was incident adjudicated dementia, based on 3MS, hospital records, and dementia drugs. Secondary outcome was change in 3MS. Models were adjusted for age, sex, race, education, and baseline 3MS, and then further for cardiovascular risk factors. RESULTS Among 2558 adults, 85% were euthyroid (TSH 0.45-4.49mIU/L), 2% had subclinical hyperthyroidism with mildly decreased TSH (TSH 0.10- 0.44mIU/L), 1% subclinical hyperthyroidism with suppressed TSH (TSH<0.10mIU/L with normal free thyroxine [FT4]) and 12% subclinical hypothyroidism (TSH 4.50-19.99mIU/L with normal FT4). Over 9 years, 22% developed dementia. Compared to euthyroidism, risk of dementia was higher in participants with subclinical hyperthyroidisim with suppressed TSH (HR 2.38, 95%CI=1.13;5.04), while we found no significant association in those with mildly decreased TSH (HR 0.79, 95%CI=0.45;1.38) or with subclinical hypothyroidism (HR 0.91, 95%CI=0.70;1.19). Participants with subclinical hyperthyroidism with suppressed TSH had a larger decline in 3MS (-3.89, 95%CI=-7.62;-0.15). CONCLUSIONS Among older adults, subclinical hyperthyroidism with a TSH<0.10mIU/L was associated with a higher risk of dementia and a larger cognitive decline, while subclinical hyperthyroidism with mildly decreased TSH or subclinical hypothyroidism were not. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Aubert, Carole Elodie; Da Costa, Bruno; Feller, Martin; Rieben, Carole and Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0300-0664

Publisher:

Blackwell Scientific Publications

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

12 Sep 2017 12:16

Last Modified:

30 Aug 2018 02:30

Publisher DOI:

10.1111/cen.13458

PubMed ID:

28850708

Uncontrolled Keywords:

Dementia, Cognitive decline, Cognitive aging, Thyroid dysfunction

BORIS DOI:

10.7892/boris.105355

URI:

https://boris.unibe.ch/id/eprint/105355

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