Subclinical Thyroid Dysfunction and Functional Capacity Among Elderly
Open accessAbstract
Background: Subclinical thyroid dysfunction is common among older people and has been associated with decreased functional capacity but with conflicting data. The aim of this study was to assess the association between subclinical thyroid dysfunction and functional capacity in an elderly population. Methods: We included 5182 participants with a mean age of 75.2 years from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). Self-reported functional capacity was assessed using the Barthel Index (BI) and the Instrumental Activities of Daily Living (IADL) scores at baseline and during follow-up. Participants with subclinical hyperthyroidism ( n =65) and subclinical hypothyroidism ( n =173) were compared to euthyroid participants ( n =4944). The association between persistent subclinical thyroid dysfunction and functional capacity and decline was also investigated. Results: At baseline, compared to euthyroid participants (BI 19.73±SE 0.06; IADL 13.52±0.02), there was no difference in functional capacity for participants with subclinical hyperthyroidism (BI 19.60±0.09; IADL 13.51±0.12, p >0.05) or subclinical hypothyroidism (BI 19.82±0.06; IADL 13.55±0.08, p >0.05). Over a mean 3.2-year follow-up period, there was no association between thyroid function and annual decline of either BI or IADL ( p >0.05). No association was found between persistent subclinical thyroid dysfunction and functional capacity at baseline or during follow-up ( p >0.05). Results were similar after excluding participants with a maximum BI and/or IADL score at baseline. Conclusion: Among well-functioning community-dwelling elderly, we found no evidence that subclinical thyroid dysfunction contributes to decreased functional capacity.
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Two recent prospective studies did not find an association between low serum TSH levels and the risk of cognitive impairment and dementia or decreased functional capacity in the elderly.
“At variance, two recent prospective studies did not find an association between low serum TSH levels and the risk of cognitive impairment and dementia or decreased functional capacity in the elderly [61,62] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [62]
Four studies have investigated whether SH is associated with self-reported functional capacity or objective measures of physical functioning.
“Four studies have investigated whether SH is associated with self-reported functional capacity or objective measures of physical functioning (420, 423-425).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [424]
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Kurzweil, E., Nissan, R., Sharir-Levy, D., Elazar, A., Kornyukov, N., & Hershkovitz, A. (2026) · Archives of Gerontology and Geriatrics Plus · doi:10.1016/j.aggp.2026.100267
- Authors
- Virgini, V. S., Wijsman, L. W., Rodondi, N., Bauer, D. C., Kearney, P. M., Gussekloo, J., den Elzen, W. P. J., Jukema, J. W., Westendorp, R. G. J., Ford, I., Stott, D. J., & Mooijaart, S. P.
- Affiliations
- University Hospital of Bern (CH)
- Leiden University Medical Center (NL)
- San Francisco University Medical Center
- University College Cork (IE)
- Leiden University Medical Center
- University of Glasgow (GB)
- Corresponding author
- Mooijaart, Simon P.
- ORCID
- Venue
- Thyroid®
- Publisher
- SAGE Publications
- Published
- 2014-02
- Volume
- 24
- Issue
- 2
- Pages
- 208-214
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- PMC
- PMC3926182
- OpenAlex
- W1970326917
- Cited by
- 44
- References
- 43
- Citations by year
- 2026: 3 · 2025: 3 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 4 · 2017: 3 · 2016: 4 · 2015: 7 · 2014: 6
- FWCI
- 4.47
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Thyroid (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, other-oa)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Open Access CRIS of the University of Bern
- Funders
- National Science Foundation
- Bristol-Myers Squibb
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (138267, 320030)
- Schweizerische Herzstiftung
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (K24AR051895)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- subclinical thyroid dysfunction, subclinical hyperthyroidism, subclinical hypothyroidism, functional capacity, older adults, Barthel Index, instrumental activities of daily living, functional decline, community-dwelling older adults, PROSPER trial
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Female, Humans, Hyperthyroidism, Hypothyroidism, Male, Prospective Studies, Risk Factors, Thyroid Diseases, Thyroid Gland, Thyrotropin, Thyroxine
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