Skip to main content
Erschienen in: Journal of Endocrinological Investigation 9/2017

01.09.2017 | Original Article

Prevalence of thyroid dysfunction and its impact on cognition in older mexican adults: (SADEM study)

verfasst von: T. Juárez-Cedillo, L. Basurto-Acevedo, S. Vega-García, A. Sánchez-Rodríguez Martha, R. Retana-Ugalde, E. Juárez-Cedillo, C. Gonzalez-Melendez Roberto, J. Escobedo-de-la-peña

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 9/2017

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Subclinical thyroid dysfunction is a possible risk factor for cognitive impairment in old age, but results are inconsistent. Aim of the present study was to evaluate the prevalence of thyroid dysfunction among older community-dwelling adults and to see whether thyroid function impacts the cognitive status of the elderly.

Methods

We included 1750 participants from the Study on Aging and Dementia in Mexico (SADEM). All subjects were evaluated clinically via specific interviews. TSH levels were analyzed by chemiluminescent immunometry assay. We classified participants into five thyroid state groups: (1) normal TSH levels (0.40–4.0 IU/L) were considered euthyroid; (2) Overt hyperthyroidism: TSH <0.3 IU/l and FT4 >23 pmol/l; (3) Overt hypothyroidism: TSH >4.8 IU/l, FT4 <13 pmol/l; (4) Subclinical hyperthyroidism: TSH <0.3 IU/l, FT4: 13–23 pmol/l; (5) Subclinical hypothyroidism: TSH >4.8 IU/l, FT4: 13–23 pmol/l.

Results

The overall estimated prevalence of thyroid dysfunction in Mexican population was 23.7% (95% CI, 22.66–26.77). Of these, 15.4% older adults were classified as subclinical hypothyroidism, 7.2% overt hypothyroidism, 0.5% subclinical hyperthyroidism, and 0.6% overt hyperthyroidism. The association of thyroid dysfunction with cognitive impairment was most evident in overt hypothyroidism OR = 1.261 (1.185–1.343).

Conclusions

The present study demonstrated a high prevalence of thyroid dysfunction in Mexican elderly people living in the community. A relationship between cognitive impairment and the presence of hypothyroidism was also shown, and to a lesser degree in hyperthyroidism.
Literatur
1.
Zurück zum Zitat Grossman A, Weiss A, Koren-Morag N et al (2016) Subclinical thyroid disease and mortality in the elderly: a retrospective cohort study. Am J Med 129:423–430CrossRefPubMed Grossman A, Weiss A, Koren-Morag N et al (2016) Subclinical thyroid disease and mortality in the elderly: a retrospective cohort study. Am J Med 129:423–430CrossRefPubMed
2.
Zurück zum Zitat Robles-Osorio ML, Zacarías-Rangel V, García-Solís P (2014) Prevalence of thyroid function test abnormalities and anti-thyroid antibodies in an open population in Central México. Rev Invest Clin 66:113–120PubMed Robles-Osorio ML, Zacarías-Rangel V, García-Solís P (2014) Prevalence of thyroid function test abnormalities and anti-thyroid antibodies in an open population in Central México. Rev Invest Clin 66:113–120PubMed
3.
Zurück zum Zitat Canaris GJ, Manowitz NR, Mayor G et al (2000) The Colorado thyroid disease prevalence study. Arch Intern Med 160:526–534CrossRefPubMed Canaris GJ, Manowitz NR, Mayor G et al (2000) The Colorado thyroid disease prevalence study. Arch Intern Med 160:526–534CrossRefPubMed
4.
Zurück zum Zitat Smith JW, Evans AT, Costall B et al (2002) Thyroid hormones, brain function and cognition: a brief review. Neurosci Biobehav. 26:45–60CrossRef Smith JW, Evans AT, Costall B et al (2002) Thyroid hormones, brain function and cognition: a brief review. Neurosci Biobehav. 26:45–60CrossRef
5.
Zurück zum Zitat Moura Neto A, Parisi MC, Tambascia MA et al (2013) Relationship of thyroid hormone levels and cardiovascular events in patients with type 2 diabetes. Endocr 45:84–91CrossRef Moura Neto A, Parisi MC, Tambascia MA et al (2013) Relationship of thyroid hormone levels and cardiovascular events in patients with type 2 diabetes. Endocr 45:84–91CrossRef
6.
Zurück zum Zitat Vitale G, Fatti LM, Prolo S, Girola A et al (2010) Screening for hypothyroidism in older hospitalized patients with anemia: a new insight into an old disease. J Am Geriatr Soc 58:1825–1827CrossRefPubMed Vitale G, Fatti LM, Prolo S, Girola A et al (2010) Screening for hypothyroidism in older hospitalized patients with anemia: a new insight into an old disease. J Am Geriatr Soc 58:1825–1827CrossRefPubMed
7.
Zurück zum Zitat Simonsick EM, Newman AB, Ferrucci L et al (2009) Subclinical hypothyroidism and functional mobility in older adults. Arch Intern Med 169:2011–2017CrossRefPubMedPubMedCentral Simonsick EM, Newman AB, Ferrucci L et al (2009) Subclinical hypothyroidism and functional mobility in older adults. Arch Intern Med 169:2011–2017CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Cooper DS, Halpern R, Wood LC, Levin AA, Ridgway EC (1984) L-thyroxine therapy in subclinical hypothyroidism. A double-blind, placebo-controlled trial. Ann Intern Med 101:18–24CrossRefPubMed Cooper DS, Halpern R, Wood LC, Levin AA, Ridgway EC (1984) L-thyroxine therapy in subclinical hypothyroidism. A double-blind, placebo-controlled trial. Ann Intern Med 101:18–24CrossRefPubMed
9.
Zurück zum Zitat Biondi B, Cooper DS (2008) The clinical significance of subclinical thyroid dysfunction. Endocr Rev 29:76–131CrossRefPubMed Biondi B, Cooper DS (2008) The clinical significance of subclinical thyroid dysfunction. Endocr Rev 29:76–131CrossRefPubMed
10.
Zurück zum Zitat Benseñor IM, Goulart AC, Lotufo PA et al (2011) Prevalence of thyroid disorders among older people: results from the Sao Paulo Ageing and Health Study. Cad Saude Publ 27:155–161CrossRef Benseñor IM, Goulart AC, Lotufo PA et al (2011) Prevalence of thyroid disorders among older people: results from the Sao Paulo Ageing and Health Study. Cad Saude Publ 27:155–161CrossRef
11.
Zurück zum Zitat Di Liegro I (2008) Thyroid hormones and the central nervous system of mammals (Review). Mol Med Rep 1:279–295 Di Liegro I (2008) Thyroid hormones and the central nervous system of mammals (Review). Mol Med Rep 1:279–295
12.
Zurück zum Zitat Dorr M, Volzke H (2005) Cardiovascular morbidity and mortality in thyroid dysfunction. Min Endocrinol 30:199–216 Dorr M, Volzke H (2005) Cardiovascular morbidity and mortality in thyroid dysfunction. Min Endocrinol 30:199–216
13.
Zurück zum Zitat Kalmijn S, Mehta KM, Pols HA et al (2000) Subclinical hyperthyroidism and the risk of dementia. The Rotterdam study. Clin Endocrinol (Oxf) 53:733–737CrossRef Kalmijn S, Mehta KM, Pols HA et al (2000) Subclinical hyperthyroidism and the risk of dementia. The Rotterdam study. Clin Endocrinol (Oxf) 53:733–737CrossRef
14.
Zurück zum Zitat van Boxtel MP, Menheere PP, Bekers O et al (2004) Thyroid function, depressed mood, and cognitive performance in older individuals: the Maastricht Aging Study. Psychoneuroendocrinology 29:891–898CrossRefPubMed van Boxtel MP, Menheere PP, Bekers O et al (2004) Thyroid function, depressed mood, and cognitive performance in older individuals: the Maastricht Aging Study. Psychoneuroendocrinology 29:891–898CrossRefPubMed
15.
Zurück zum Zitat Parsaik AK, Singh B, Roberts RO et al (2014) Hypothyroidism and risk of mild cognitive impairment in elderly persons: a population-based study. JAMA Neurol 71:201–207CrossRefPubMedPubMedCentral Parsaik AK, Singh B, Roberts RO et al (2014) Hypothyroidism and risk of mild cognitive impairment in elderly persons: a population-based study. JAMA Neurol 71:201–207CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat van Osch LA, Hogervorst E, Combrinck M et al (2004) Low thyroid-stimulating hormone as an independent risk factor for Alzheimer disease. Neurology 62:1967–1971CrossRefPubMed van Osch LA, Hogervorst E, Combrinck M et al (2004) Low thyroid-stimulating hormone as an independent risk factor for Alzheimer disease. Neurology 62:1967–1971CrossRefPubMed
17.
Zurück zum Zitat Roberts LM, Pattison H, Roalfe A et al (2006) Is subclinical thyroid dysfunction in the elderly associated with depression or cognitive dysfunction? Ann Int Med 145:573–581CrossRefPubMed Roberts LM, Pattison H, Roalfe A et al (2006) Is subclinical thyroid dysfunction in the elderly associated with depression or cognitive dysfunction? Ann Int Med 145:573–581CrossRefPubMed
18.
Zurück zum Zitat Park YJ, Lee EJ, Lee YJ et al (2010) Subclinical hypothyroidism (SCH) is not associated with metabolic derangement, cognitive impairment, depression or poor quality of life (QoL) in elderly subjects. Arch Gerontol Geriatr 50:e68–e73CrossRefPubMed Park YJ, Lee EJ, Lee YJ et al (2010) Subclinical hypothyroidism (SCH) is not associated with metabolic derangement, cognitive impairment, depression or poor quality of life (QoL) in elderly subjects. Arch Gerontol Geriatr 50:e68–e73CrossRefPubMed
19.
Zurück zum Zitat Kramer CK, von Muhlen D, Kritz-Silverstein D et al (2009) Treated hypothyroidism, cognitive function, and depressed mood in old age: the Rancho Bernardo Study. Eur J Endocrinol 161:917–921CrossRefPubMed Kramer CK, von Muhlen D, Kritz-Silverstein D et al (2009) Treated hypothyroidism, cognitive function, and depressed mood in old age: the Rancho Bernardo Study. Eur J Endocrinol 161:917–921CrossRefPubMed
20.
Zurück zum Zitat Tan ZS, Vasan RS (2009) Thyroid function and Alzheimer’s disease. J Alzheimer’s Dis 16:503–507CrossRef Tan ZS, Vasan RS (2009) Thyroid function and Alzheimer’s disease. J Alzheimer’s Dis 16:503–507CrossRef
21.
Zurück zum Zitat Juarez-Cedillo T, Sanchez-Arenas R, Sanchez-Garcia S et al (2012) Prevalence of mild cognitive impairment and its subtypes in the Mexican population. Dement Geriatr Cogn Disord 34:271–281CrossRefPubMed Juarez-Cedillo T, Sanchez-Arenas R, Sanchez-Garcia S et al (2012) Prevalence of mild cognitive impairment and its subtypes in the Mexican population. Dement Geriatr Cogn Disord 34:271–281CrossRefPubMed
22.
Zurück zum Zitat Juárez-Cedillo T, Basurto-Acevedo L, Vega-García S et al (2014) Prevalence of anemia and its impact on the state of frailty in elderly people living in the community: SADEM study. Ann Hematol 93:2057–2062CrossRefPubMed Juárez-Cedillo T, Basurto-Acevedo L, Vega-García S et al (2014) Prevalence of anemia and its impact on the state of frailty in elderly people living in the community: SADEM study. Ann Hematol 93:2057–2062CrossRefPubMed
23.
Zurück zum Zitat Fernandez MJ, Basurto L, Córdova N et al (2014) Epicardial adipose tissue is associated with visceral fat, metabolic syndrome, and insulin resistance in menopausal women. Rev Esp Cardiol 67:436–441CrossRef Fernandez MJ, Basurto L, Córdova N et al (2014) Epicardial adipose tissue is associated with visceral fat, metabolic syndrome, and insulin resistance in menopausal women. Rev Esp Cardiol 67:436–441CrossRef
24.
Zurück zum Zitat Franco-Marina F, García-González JJ, Wagner-Echeagaray F et al (2010) The Mini-mental State Examination revisited: ceiling and floor effects after score adjustment for educational level in an aging Mexican population. Int Psychogeriatr 22:72–81CrossRefPubMed Franco-Marina F, García-González JJ, Wagner-Echeagaray F et al (2010) The Mini-mental State Examination revisited: ceiling and floor effects after score adjustment for educational level in an aging Mexican population. Int Psychogeriatr 22:72–81CrossRefPubMed
25.
Zurück zum Zitat Reyes-Beaman S, Beaman PE, García-Peña C et al (2004) Validation of a modified version of the Minimental State Examination (MMSE) in Spanish. Aging Neuropsychol Cognit 11:1–11CrossRef Reyes-Beaman S, Beaman PE, García-Peña C et al (2004) Validation of a modified version of the Minimental State Examination (MMSE) in Spanish. Aging Neuropsychol Cognit 11:1–11CrossRef
26.
Zurück zum Zitat McKhann G, Drachman D, Folstein M et al (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 34:939–944CrossRefPubMed McKhann G, Drachman D, Folstein M et al (1984) Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 34:939–944CrossRefPubMed
27.
Zurück zum Zitat Katz S, Akpom CA (1976) A measure of primary sociobiological functions. Int J Health 6:493–507 Katz S, Akpom CA (1976) A measure of primary sociobiological functions. Int J Health 6:493–507
28.
Zurück zum Zitat Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186CrossRefPubMed Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186CrossRefPubMed
29.
Zurück zum Zitat Zúniga MA, Carrillo-Jiménez GT, Fos PJ (1999) Evaluation of health status using survey SF-36: preliminary results in Mexico. Salud Publica Mex 41:110–118CrossRefPubMed Zúniga MA, Carrillo-Jiménez GT, Fos PJ (1999) Evaluation of health status using survey SF-36: preliminary results in Mexico. Salud Publica Mex 41:110–118CrossRefPubMed
30.
Zurück zum Zitat Brazier E, Harper R, Jones NMB et al (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305:160–164CrossRefPubMedPubMedCentral Brazier E, Harper R, Jones NMB et al (1992) Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 305:160–164CrossRefPubMedPubMedCentral
31.
Zurück zum Zitat Eaton W, Muntaner C, Smith C (1998) Revision of the Center for epidemiologic studies depression (CES-D) Scale. John Hopkins University Prevention Center, Baltimore Eaton W, Muntaner C, Smith C (1998) Revision of the Center for epidemiologic studies depression (CES-D) Scale. John Hopkins University Prevention Center, Baltimore
32.
Zurück zum Zitat Reyes M, Soto AL, Milla JG et al (2003) Actualización de la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D). Estudio piloto en una muestra geriátrica mexicana. Salud Ment 26:59–68 Reyes M, Soto AL, Milla JG et al (2003) Actualización de la Escala de Depresión del Centro de Estudios Epidemiológicos (CES-D). Estudio piloto en una muestra geriátrica mexicana. Salud Ment 26:59–68
33.
Zurück zum Zitat Garber JR, Cobin RH, Gharib H et al (2012) Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract 18:989–1028CrossRef Garber JR, Cobin RH, Gharib H et al (2012) Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract 18:989–1028CrossRef
34.
Zurück zum Zitat Gussekloo J, van Exel E, de Craen AJ (2004) Thyroid status, disability and cognitive function, and survival in old age. JAMA 292:2591–2595CrossRefPubMed Gussekloo J, van Exel E, de Craen AJ (2004) Thyroid status, disability and cognitive function, and survival in old age. JAMA 292:2591–2595CrossRefPubMed
35.
Zurück zum Zitat Medrano ME, Santillana-Hernández SP, Torres-Arreola LP et al (2012) Diagnóstico y tratamiento del hipotiroidismo primario en adultos. Rev Med Inst Mex Seguro Soc 50:71–80 Medrano ME, Santillana-Hernández SP, Torres-Arreola LP et al (2012) Diagnóstico y tratamiento del hipotiroidismo primario en adultos. Rev Med Inst Mex Seguro Soc 50:71–80
36.
Zurück zum Zitat SPSS Inc (2015) SPSS Base 23.0 for Windows User’s Guide. SPSS Inc., Chicago SPSS Inc (2015) SPSS Base 23.0 for Windows User’s Guide. SPSS Inc., Chicago
37.
Zurück zum Zitat Samuels MH (2010) Cognitive function in subclinical hypothyroidism. J Clin Endocrinol Meta 95:3611–3613CrossRef Samuels MH (2010) Cognitive function in subclinical hypothyroidism. J Clin Endocrinol Meta 95:3611–3613CrossRef
38.
Zurück zum Zitat Pasqualetti G, Pagano G, Rengo G et al (2015) Subclinical hypothyroidism and cognitive impairment: a systematic review and meta-analysis. J Clin Endocrinol Metab 25:2046 Pasqualetti G, Pagano G, Rengo G et al (2015) Subclinical hypothyroidism and cognitive impairment: a systematic review and meta-analysis. J Clin Endocrinol Metab 25:2046
39.
Zurück zum Zitat Cook SE, Nebes RD, Halligan EM et al (2002) Memory impairment in elderly individuals with mildly elevated serum TSH: the role of processing resources, depression and cerebrovascular disease. Aging 9:175–183 Cook SE, Nebes RD, Halligan EM et al (2002) Memory impairment in elderly individuals with mildly elevated serum TSH: the role of processing resources, depression and cerebrovascular disease. Aging 9:175–183
40.
Zurück zum Zitat Manciet G, Dartigues JF, Decamps A (1995) The PAQUID survey and correlates of subclinical hypothyroidism in elderly community residents in the southwest of France. Age Aging 24:235–241CrossRef Manciet G, Dartigues JF, Decamps A (1995) The PAQUID survey and correlates of subclinical hypothyroidism in elderly community residents in the southwest of France. Age Aging 24:235–241CrossRef
41.
42.
Zurück zum Zitat Castellano CA, Laurin D, Langlois MF, Fortier M et al (2013) Thyroid function and cognition in the euthyroid elderly: a case-control study embedded in Quebec longitudinal study - NuAge. Psychoneuroendocrinology 38:1772–1776CrossRefPubMed Castellano CA, Laurin D, Langlois MF, Fortier M et al (2013) Thyroid function and cognition in the euthyroid elderly: a case-control study embedded in Quebec longitudinal study - NuAge. Psychoneuroendocrinology 38:1772–1776CrossRefPubMed
43.
Zurück zum Zitat Coene KL, Demir AY, Broeren MA et al (2015) Subclinical hypothyroidism: a “laboratory-induced” condition? Eur J Endocrinol 173:499–505CrossRefPubMed Coene KL, Demir AY, Broeren MA et al (2015) Subclinical hypothyroidism: a “laboratory-induced” condition? Eur J Endocrinol 173:499–505CrossRefPubMed
44.
Zurück zum Zitat Ceresini G, Lauretani F, Maggio M (2009) Thyroid function abnormalities and cognitive impairment in elderly people: results of the Invecchiare in Chianti study. J Am Geriatr Soc 57:89–93CrossRefPubMed Ceresini G, Lauretani F, Maggio M (2009) Thyroid function abnormalities and cognitive impairment in elderly people: results of the Invecchiare in Chianti study. J Am Geriatr Soc 57:89–93CrossRefPubMed
45.
Zurück zum Zitat Kim JM, Stewart R, Kim SY et al (2010) Thyroid Stimulating Hormone, cognitive impairment and depression in an older Korean population. Psychiatry Investig 7:262–269 Kim JM, Stewart R, Kim SY et al (2010) Thyroid Stimulating Hormone, cognitive impairment and depression in an older Korean population. Psychiatry Investig 7:262–269
Metadaten
Titel
Prevalence of thyroid dysfunction and its impact on cognition in older mexican adults: (SADEM study)
verfasst von
T. Juárez-Cedillo
L. Basurto-Acevedo
S. Vega-García
A. Sánchez-Rodríguez Martha
R. Retana-Ugalde
E. Juárez-Cedillo
C. Gonzalez-Melendez Roberto
J. Escobedo-de-la-peña
Publikationsdatum
01.09.2017
Verlag
Springer International Publishing
Erschienen in
Journal of Endocrinological Investigation / Ausgabe 9/2017
Elektronische ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-017-0654-6

Weitere Artikel der Ausgabe 9/2017

Journal of Endocrinological Investigation 9/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Ist Fasten vor Koronarinterventionen wirklich nötig?

Wenn Eingriffe wie eine Koronarangiografie oder eine Koronarangioplastie anstehen, wird häufig empfohlen, in den Stunden zuvor nüchtern zu bleiben. Ein französisches Forscherteam hat diese Maßnahme hinterfragt.

Typ-2-Diabetes: Ernährungsunsicherheit vervierfacht Risiko für schwere Hypoglykämien

04.06.2024 Typ-2-Diabetes Nachrichten

Wenn ältere Menschen mit Typ-2-Diabetes Schwierigkeiten beim Beschaffen und Zubereiten von Mahlzeiten haben, geht dies mit einem deutlich gesteigerten Risiko für schwere Hypoglykämien einher.

Mehr Brustkrebs, aber weniger andere gynäkologische Tumoren mit Levonorgestrel-IUS

04.06.2024 Levonorgestrel Nachrichten

Unter Frauen, die ein Levonorgestrel-freisetzendes intrauterines System (IUS) verwenden, ist die Brustkrebsrate um 13% erhöht. Dafür kommt es deutlich seltener zu Endometrium-, Zervix- und Ovarialkarzinomen.

GLP-1-Agonist Semaglutid wirkt kardio- und nephroprotektiv

03.06.2024 Semaglutid Nachrichten

Der GLP-1-Agonist Semaglutid hat in der FLOW-Studie bewiesen, dass sich damit die Progression chronischer Nierenerkrankungen bei Patienten mit Typ-2-Diabetes bremsen lässt. Auch in kardiovaskulärer Hinsicht war die Therapie erfolgreich.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.