The Thyroid in Mind: Cognitive Function and Low Thyrotropin in Older People
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CONTEXT: Several studies have reported an association between low serum TSH, or subclinical hyperthyroidism (SH), and dementia, but little emphasis has been placed on this field because not all studies have demonstrated the same association. We performed a detailed systematic review to assess the evidence available to support the association between these two conditions. METHODS: We performed a systematic search through the PubMed, Embase (1996 to 2012 wk 4), Cochrane Library, and Medline (1996 to January wk 4, 2012) electronic databases using key search terms encompassing subclinical hyperthyroidism, TSH, dementia, and cognitive impairment. RESULTS: This review examines the 23 studies that provide information about the association between SH or lower serum TSH within the reference range and cognition. Fourteen of these studies, including several well-designed and well-powered cross-sectional and longitudinal analyses, have shown a consistent finding of an association between SH with cognitive impairment or dementia. CONCLUSION: There is a substantial body of evidence to support the association between SH and cognitive impairment, but there is no clear mechanistic explanation for these associations. Nor is there an indication that antithyroid treatment might ameliorate dementia. Larger and more detailed prospective longitudinal or randomized controlled trials are required to inform these important questions.
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A recent systematic review provided evidence for an association between subclinical hyperthyroidism or low serum TSH within the reference range and cognitive impairment or dementia.
“A recent systematic review provided evidence for an association between SHyper or low serum TSH within the reference range and cognitive impairment or dementia [59] .”
From The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism (2015) · cites this paper as [59]
A large body of literature has investigated possible correlations between SH and cognitive decline.
“A large body of literature has investigated possible correlations between SH and cognitive decline [reviewed by Gan and Pearce (418), with more recent studies by others (419,420)].”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [418]
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- Authors
- Gan, E. H., & Pearce, S. H. S.
- Affiliations
- Royal Victoria Infirmary (GB)
- Corresponding author
- Gan, Earn H.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2012-10
- Volume
- 97
- Issue
- 10
- Pages
- 3438-3449
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC3496329
- OpenAlex
- W2012871126
- Cited by
- 93
- References
- 81
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 8 · 2020: 8 · 2019: 5 · 2018: 6 · 2017: 6 · 2016: 10 · 2015: 5 · 2014: 10 · 2013: 9 · 2012: 1
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Newcastle University
- Medical Research Council (G0500783)
- 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 › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- subclinical hyperthyroidism, dementia, cognitive impairment, older adults, antithyroid drug therapy
- MeSH terms
- Aged, Cognition, Cognition Disorders, Humans, Hyperthyroidism, Thyroid Gland, Thyrotropin
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