Subclinical Thyroid Dysfunction and the Risk of Cognitive Decline: a Meta-Analysis of Prospective Cohort Studies.

Rieben, Carole; Segna, Daniel; Da Costa, Bruno; Collet, Tinh-Hai; Chaker, Layal; Aubert, Carole E; Baumgartner, Christine; Almeida, Osvaldo P; Hogervorst, Eef; Trompet, Stella; Masaki, Kamal; Mooijaart, Simon P; Gussekloo, Jacobijn; Peeters, Robin P; Bauer, Douglas C; Aujesky, Drahomir; Rodondi, Nicolas (2016). Subclinical Thyroid Dysfunction and the Risk of Cognitive Decline: a Meta-Analysis of Prospective Cohort Studies. Journal of clinical endocrinology and metabolism, 101(12), pp. 4945-4954. Endocrine Society 10.1210/jc.2016-2129

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CONTEXT Although both overt hyper- and hypothyroidism are known to lead to cognitive impairment, data on the association between subclinical thyroid dysfunction and cognitive function are conflicting. OBJECTIVE This study sought to determine the risk of dementia and cognitive decline associated with subclinical thyroid dysfunction among prospective cohorts. DATA SOURCES We searched in MEDLINE and EMBASE from inception until November 2014. STUDY SELECTION Two physicians identified prospective cohorts that assessed thyroid function and cognitive outcomes (dementia; Mini-Mental State Examination [MMSE]). DATA EXTRACTION Data were extracted by one reviewer following standardized protocols and verified by a second reviewer. The primary outcome was dementia and decline in cognitive function was the secondary outcome. DATA SYNTHESIS Eleven prospective cohorts followed 16,805 participants during a median followup of 44.4 months. Five studies analyzed the risk of dementia in subclinical hyperthyroidism (SHyper) (n = 6410), six in subclinical hypothyroidism (SHypo) (n = 7401). Five studies analyzed MMSE decline in SHyper (n = 7895), seven in SHypo (n = 8960). In random-effects models, the pooled adjusted risk ratio for dementia in SHyper was 1.67 (95% confidence interval, 1.04; 2.69) and 1.14 (95% confidence interval, 0.84; 1.55) in SHypo vs euthyroidism, both without evidence of significant heterogeneity (I(2) = 0.0%). The pooled mean MMSE decline from baseline to followup (mean 32 mo) did not significantly differ between SHyper or SHypo vs euthyroidism. CONCLUSIONS SHyper might be associated with an elevated risk for dementia, whereas SHypo is not, and both conditions are not associated with faster decline in MMSE over time. Available data are limited, and additional large, high-quality studies are needed.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
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 > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Rieben, Carole; Segna, Daniel; Da Costa, Bruno; Aubert, Carole Elodie; Baumgartner, Christine; Aujesky, Drahomir and Rodondi, Nicolas

Subjects:

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

ISSN:

0021-972X

Publisher:

Endocrine Society

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

30 Dec 2016 14:09

Last Modified:

01 Oct 2017 02:30

Publisher DOI:

10.1210/jc.2016-2129

PubMed ID:

27689250

BORIS DOI:

10.7892/boris.92322

URI:

https://boris.unibe.ch/id/eprint/92322

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