Does low-normal serum TSH level adversely impact cognition in elderly adults and might methimazole therapy improve outcomes?

Endocrine Journal

Patrícia dos Santos Vigário²  Silvana Oliveira e Silva¹  Michele Lopes Fagundes¹  Patrícia de F. dos S. Teixeira¹  Dhiãnah Santini de Oliveira Chachamovitz¹  Letícia B. B. de Mello Teixeira¹  Mário Vaisman¹ 

[1] Medicine School - Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;Ergospirometry and Kinanthropometry Laboratory, Physical Education and Sports School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

关键词: Elderly;    Cognition;    Depression;    TSH;   

DOI  :  10.1507/endocrj.EJ15-0458

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(39)Cited-By(1)Serum thyroid stimulating hormone (TSH) levels increase with age.This elevation has been associated with better outcomes in very elderly subjects; however, little is known about the relationship between TSH below the lower limit of the reference range and health-related outcomes.Here, we investigated the association between cognitive impairment or depressive symptoms and low-normal serum TSH (<1.0 μIU/mL, in the reference range) in elderly subjects and whether the use of methimazole in subjects without dementia but with low-normal TSH could affect cognition or depressive symptoms.From 293 healthy adults ≥65 years old with normal TSH included in the sectional phase, only subjects without dementia were prospectively analyzed: 1) TSH ≥1.0 μIU/mL (observation; untreated); 2) TSH <1.0 μIU/mL (observation; untreated); and 3) TSH <1.0 μIU/mL (methimazole therapy).Cognition was assessed, using the Mini Mental State Examination (MMSE) and depressive symptoms (at MMSE ≥ 13) by the Geriatric Depression Scale (GDS).Age >80 years was the sole independent factor associated with dementia (OR=2.89; confidence interval [CI] 1.72-4.86; p<0.01).Prospectively, 93 completed follow-up, with 7.5% (7) receiving methimazole intervention.Untreated subjects with lower TSH showed the greatest declines in MMSE scores during follow-up that was not observed in those with serum TSH ≥1.0 μIU/mL.Lower MMSE score reductions were associated with elderly subjects receiving methimazole.There were no significant changes in depressive symptoms and GDS scores among those with serum TSH <1.0 μIU/mL.In this study, low-normal TSH was not associated with higher prevalence of dementia.However, in elderly subjects without dementia, low TSH was associated with worsening cognition.

【 授权许可】

Unknown