The association between subclinical thyroid dysfunction and dementia: The Health, Aging and Body Composition (Health ABC) Study
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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 0.10-0.44 mIU/L), 1% subclinical hyperthyroidism with suppressed TSH (TSH < 0.10 mIU/L with normal free thyroxine [FT4]) and 12% subclinical hypothyroidism (TSH 4.50-19.99 mIU/L with normal FT4). Over 9 years, 22% developed dementia. Compared to euthyroidism, risk of dementia was higher in participants with subclinical hyperthyroidism 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 < 0.10 mIU/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.
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Apart from higher mortality in patients with suppressed TSH, the most important risks of overtreatment affect the heart, bones, brain, and muscle function.
“Apart from the higher mortality in patients with suppressed TSH the most important risks of overtreatment are those affecting the heart (50), the bones (91), the brain (92) and muscle function (93).”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [92]
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- Authors
- Aubert, C. E., Bauer, D. C., da Costa, B. R., Feller, M., Rieben, C., Simonsick, E. M., Yaffe, K., Rodondi, N., & Study, T. H. A.
- Affiliations
- University of Bern (CH)
- University of California, San Francisco (US)
- Institute of Primary Health Care (BIHAM) University of Bern Bern Switzerland
- National Institute on Aging (US)
- Corresponding author
- Aubert, Carole E.
- ORCID
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2017-09-14
- Volume
- 87
- Issue
- 5
- Pages
- 617-626
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- PMC
- PMC5658241
- OpenAlex
- W2752204234
- Cited by
- 87
- References
- 37
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 10 · 2023: 7 · 2022: 16 · 2021: 21 · 2020: 13 · 2019: 3 · 2018: 9
- FWCI
- 5.41
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- BORIS (University Library Bern) (submittedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Open Access CRIS of the University of Bern
- Funders
- Institute of Aging (N01‐AG‐6‐2101, N01‐AG‐6‐2103, N01‐AG‐6‐2106)
- National Institute on Aging
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (SNSF 320030‐150025)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- subclinical hyperthyroidism, subclinical hypothyroidism, dementia, cognitive decline, TSH suppression, older adults, thyroid function, incident dementia risk
- MeSH terms
- Aged, Dementia, Humans, Hyperthyroidism, Hypothyroidism, Prospective Studies, Thyroid Gland, Thyrotropin
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