Subclinical thyroid dysfunction and cognitive decline in old age

Wijsman, Liselotte W; de Craen, Anton J M; Trompet, Stella; Gussekloo, Jacobijn; Stott, David J; Rodondi, Nicolas; Welsh, Paul; Jukema, J Wouter; Westendorp, Rudi G J; Mooijaart, Simon P (2013). Subclinical thyroid dysfunction and cognitive decline in old age. PLoS ONE, 8(3), e59199. Public Library of Science 10.1371/journal.pone.0059199

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BACKGROUND Subclinical thyroid dysfunction has been implicated as a risk factor for cognitive decline in old age, but results are inconsistent. We investigated the association between subclinical thyroid dysfunction and cognitive decline in the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER). METHODS Prospective longitudinal study of men and women aged 70-82 years with pre-existing vascular disease or more than one risk factor to develop this condition (N = 5,154). Participants taking antithyroid medications, thyroid hormone supplementation and/or amiodarone were excluded. Thyroid function was measured at baseline: subclinical hyper- and hypothyroidism were defined as thyroid stimulating hormones (TSH) <0.45 mU/L or >4.50 mU/L respectively, with normal levels of free thyroxine (FT4). Cognitive performance was tested at baseline and at four subsequent time points during a mean follow-up of 3 years, using five neuropsychological performance tests. RESULTS Subclinical hyperthyroidism and hypothyroidism were found in 65 and 161 participants, respectively. We found no consistent association of subclinical hyper- or hypothyroidism with altered cognitive performance compared to euthyroid participants on the individual cognitive tests. Similarly, there was no association with rate of cognitive decline during follow-up. CONCLUSION We found no consistent evidence that subclinical hyper- or hypothyroidism contribute to cognitive impairment or decline in old age. Although our data are not in support of treatment of subclinical thyroid dysfunction to prevent cognitive dysfunction in later life, only large randomized controlled trials can provide definitive evidence.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Rodondi, Nicolas


600 Technology > 610 Medicine & health




Public Library of Science




Patricia Rajaonina

Date Deposited:

01 Apr 2014 09:47

Last Modified:

03 Jan 2015 20:29

Publisher DOI:


PubMed ID:





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