Screening of Geriatric Patients for Thyroid Dysfunction with Thyrotropin-Releasing-Hormone Test, Sensitive Thyrotropin and Free Thyroxine Estimation

Szabolcs, I.; Ploenes, Chr.; Bernard, Wolfdieter; Herrmann, Jörg

doi:10.1055/s-2007-1004906

Cited by 30 publications

(15 citation statements)

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“…Only one third (34.8%) of the elderly with high TSH levels in our sample had elevated serum TSH values and low serum free T4 values. This showed that the serum TSH value was a more sensitive screening test of thyroid deficiency in the elderly than the serum T4 value [6,23]. Among those with overt hypothyroidism, the prevalence in women was higher than in men.…”

Section: Discussionmentioning

confidence: 94%

Prevalence Study of Thyroid Dysfunction in the Elderly of Taiwan

Chuang

Wang

et al. 1998

Gerontology

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The present study was aimed at investigating the prevalence of thyroid dysfunction in the elderly, aged 65 years or older, in a community of southern Taiwan. By using the records of the local household registry, a sampling frame for the elderly population was constructed, and a sample of 1,400 subjects was drawn by simple random sampling. After the exclusion of nonresponse subjects, 917 subjects aged between 65 and 88 years (mean 71.9) were included in our survey. The serum thyrotropin levels of these participants were measured by monoclonal antibodies TSH immunoradiometric assays. A normal range, 0.45–4.65 µU/ml, was determined from the middle 95% of the TSH distribu- tion of 140 ‘disease-free’ subjects. By reference to the normal range, 23 (2.51%) participants had high (>4.65 µU/ml), and 41 (4.47%) had low (<0.46 µU/ml) TSH levels. The overall prevalence of thyroid dysfunction in the sample was 6.98%. Of the 23 participants with high TSH levels, 8 (34.8%) had low free T4 values (<1.21 ng/dl), so-called overt hypothyroidism, and of the 41 participants with low TSH levels, only 1 (2.4%) had high T3 values, so-called T3 thyrotoxicosis. Antithyroid antibodies were found in 56.5% of those with high TSH levels but only 12.2% of those with low TSH levels (odds ratio = 8.53, 95% confidence limits = 2.55–28.50, p < 0.001). This result indicates that autoimmune disease is still the major cause of hypothyroidism in aged people. However, the prevalence of subclinical hyperthyroidism is higher than that of subclinical hypothyroidism and it might relate to nonautoimmune factors.

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Section: Discussionmentioning

confidence: 94%

Prevalence Study of Thyroid Dysfunction in the Elderly of Taiwan

Chuang

Wang

et al. 1998

Gerontology

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“…Alguns autores concordam que, com a idade, ocorra uma diminuição dos níveis séricos de T3, T4 e FT4 (9,14,(18)(19)(20)(21)(22)(23)25,26), enquanto para outros estes se mantém inalterados (14,23,24,27) com o envelhecimento. Níveis elevados (4,8,14) de TSH, baixos (15)(16)(17) ou inalterados (18) já foram descritos na população idosa.…”

Section: Introductionunclassified

Estudo da Função Tiroideana em Uma População com Mais de 50 Anos

Mendonça

Jorge

2002

Arq Bras Endocrinol Metab

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RESUMOCom objetivo de analisar a freqüência de disfunção tiroideana e de identificar possíveis alterações hormonais decorrentes do envelhecimento, estudamos 198 indivíduos com idade variando de 50 a 85 anos e 106 filhos com idade entre 11 e 49 anos. A prevalência de disfunção tiroideana foi semelhante em ambos grupos (12,6% no grupo de estudo e 14,1% entre os filhos). A presença de um ou dois anticorpos antitiroideanos positivos foi também semelhante entre os grupos (9,1% e 12,3% para os idosos e filhos respectivamente), embora sem correlação disfunção tiroideana. nos idosos. Os níveis séricos de T3 e FT4 foram significantemente menores entre os indivíduos mais velhos quando comparados com os filhos (1,27±0,27 x 1,39±0,31 ng/ml e 0,97±0,29 x 1,18±0,76 ng/dl, respectivamente). Não houve diferença entre os grupos quanto aos níveis de TSH, T4 total e TBG. Concluímos que a prevalência de disfunção tiroideana não foi diferente entre os grupos e que a presença de anticorpos antitiroideanos esteve associada com disfunção da tiróide apenas nos indivíduos mais jovens. A correlação inversa dos níveis de T3 e FT4 com a idade pode refletir uma adaptação à menor necessidade dos hormônios com o envelhecimento. ABSTRACT Thyroid Function Studies in a Population Sample Over 50 Years of Age.We evaluated 198 subjects between 50 and 85 years of age (older group) and 106 individuals of their offspring in the age group 11-49 years (younger group) in order to determine the frequency of thyroid dysfunction and also identify possible hormonal changes due to aging. The prevalence of thyroid dysfunction was similar in both groups (12.6% in the older and 14.1% in the younger groups). The positivity to one or two antithyroid antibodies was also similar between the groups (9.1% and 12.3% for the elderly and the young, respectively), although no correlation with the thyroid dysfunction was found in the elderly. Serum T3 and FT4 levels were significantly lower in the older as compared with the younger subjects (1.27±0.27 vs 1.39±0,31 ng/mL and 0.97±0.29 vs 1.18±0.76 ng/dL, respectively). No statistical significant difference was found between the groups regarding TSH, total T4 and TBG levels. We conclude that the prevalence of thyroid dysfunction was similar between the groups and that the positivity to anti-thyroid antibodies was associated with thyroid dysfunction only in the younger subjects. The inverse correlation between T3 and FT4 levels and the age can reflect an adaptation to the lowest requirements for the hormones with the aging.

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“…TSH is a sensitive and specific screening test for hypothyroidism and has high predictive value (34). However, the lack of direct measurement of thyroid hormone levels makes it difficult to make inferences concerning possible effects of either sub-clinical hypo thyroidism or sub-clinical hyper thyroidism on cognitive function.…”

Section: Discussionmentioning

confidence: 99%

The association of thyroid stimulating hormone levels with cognitive function and depressed mood: The Rancho Bernardo study

Kritz‐Silverstein

Schultz

Palinkas

et al. 2009

The Journal of nutrition, health and aging

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Objective To evaluate the association of thyroid stimulating hormone levels with cognitive function and depressed mood in a community-based sample. Design Cross-sectional study Setting Clinic visit in 1999-2003 Participants Community-dwelling men (N=447) and women (N=663) aged 42-99 years Measurement Cognitive function was assessed with the Buschke-Fuld Selective Reminding Test, the Modified Mini-Mental State Examination, Trails B, and category fluency. Depressed mood was assessed with the Beck Depression Inventory (BDI). A fasting blood sample was obtained for thyroid stimulating hormone (TSH) measurement. Results Mean age was 73.6±10.0 in men and 74.3±10.4 in women. Mean TSH was 1.9 μIU/ml in both sexes; 9.0% of men and 24% of women reported thyroid medication use. Mean BDI scores were 4.6±4.1 in men and 5.2±4.3 in women; 9% of men and 11% of women used antidepressants. Before and after adjustment for covariates or exclusion of participants taking thyroid hormones, no associations were observed between TSH and cognitive function (ps>0.10). TSH was inversely associated with BDI (p=0.03) in men, but not women. Conclusions Thyroid stimulating hormone level was unrelated to cognitive function in men and women, and was inversely associated with depressed mood in men only, possibly reflecting the greater use of both thyroid medications and antidepressants by women.

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Screening of Geriatric Patients for Thyroid Dysfunction with Thyrotropin-Releasing-Hormone Test, Sensitive Thyrotropin and Free Thyroxine Estimation

Cited by 30 publications

References 15 publications

Prevalence Study of Thyroid Dysfunction in the Elderly of Taiwan

Prevalence Study of Thyroid Dysfunction in the Elderly of Taiwan

Estudo da Função Tiroideana em Uma População com Mais de 50 Anos

The association of thyroid stimulating hormone levels with cognitive function and depressed mood: The Rancho Bernardo study

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