And the elderly Hypothyroidism You may be at increased risk of developing dementia, especially if you are taking the thyroid gland Hormone replacement therapyNew research suggests.
The researchers analyzed the medical records of about 8,000 newly diagnosed adults (mean age 75 years).
After adjusting for other health and demographic factors that may affect the risk of dementia, the history of hypothyroidism may be associated with an 81% increase in the risk of developing dementia. Shown from the results.
In addition, people with hypothyroidism who took medication for their condition were more than three times more likely to develop dementia than those who did not.
Chien-Hsiang Weng, MD, MPH, lead author and clinical assistant professor at the Warren Alpert Medical School at Brown University in Providence, Rhode Island, said: Medscape Medical News..
“It’s important to correct thyroid function as soon as possible to identify patients with thyroid disorders and reduce the risk of some medical conditions, including dementia,” Weng said.
The survey results are Published online In the journal today Neurology.
Rapidly aging population
Over the last few decades, research has focused on the effects of thyroid hormones T3 and T4 and nutritional effects. Thyroid stimulating hormone (TSH), especially the risk of dementia, manifested in the form of asymptomatic hypothyroidism. However, the researchers write that the results are “contradictory.”
In countries with iodine-rich diets, hyperthyroidism Hypothyroidism is estimated at 0.2% to 1.3% and 1% to 2%, respectively, and women are affected by imbalance. Incidence increases as individuals grow older, reaching as high as 7% in people aged 85-89.
In Taiwan, the prevalence of dementia increased from 6.8% in 1992 to 11.1% in 2012 in the “rapidly aging population”. Therefore, especially since most previous studies were conducted in non-Asian populations, “there is an increasing need to expand and scrutinize these under-studied correlations with thyroid disorders.” Are writing.
Weng said he has been investigating the link between thyroid disorders and several other diseases, such as cancer and chronic conditions, over the past few years.
“As a primary care physician, I often see patients with poor memory in their daily practice, and I have observed that many of them have thyroid disease,” he said.
“Because of the lack of strong clinical evidence, we decided to design and conduct a large study to investigate this association,” Weng added.
Investigators conducted a national population-based case control study using the Taiwan National Health Insurance Research Database. Of the adult participants (n = 15,686), half were diagnosed with dementia between 2006 and 2013 (mean age 74.9 years) and the other half did not have dementia (mean age 74.5 years). .. Both groups were slightly predominantly female (51.8%).
Participants were matched 1: 1 by age, gender, and index date, after which the researchers confirmed whether the patient had a history of thyroid disorders.
To be included in the study, the patient must have been diagnosed with thyroid disorder on at least three clinical visits. In addition, the initial diagnosis of thyroid disorder had to be made one year before the initial diagnosis of dementia and one year before the control index date.
Researchers have adjusted their findings for sequences of potential confounders, including age, gender, and a history of several illnesses, including: High blood pressureDiabetes, Coronary artery diseaseDepression, hyperlipidemia, Alcohol addictionTinnitus DeafnessAnd radioiodine treatment.
“Robust” evidence
Of the participants, 235 had thyroid disease. Of these, 102 had hypothyroidism and 133 had hyperthyroidism.
Having a history of several medical conditions was associated with an increased risk of developing dementia across the study population.
table.Risk of developing dementia due to medical history
| Medical condition | Percentage of people with and without dementia | P worth |
|---|---|---|
| High blood pressure | 47.3% vs 40.9% | <.001 |
| Diabetes | 27.3% vs 17.8% | <.001 |
| Coronary artery disease | 15.0% vs. 12.8% | <.001 |
| depression | 2.0% vs 0.3% | <.001 |
| Tinnitus | 2.1% vs 1.6% | .013 |
| Alcohol addiction | 0.5% vs 0% | <.001 |
In addition, 0.9% of people with dementia were identified as hypothyroidism and 1% were identified as hyperthyroidism, compared with 0.4% and 0.7% in the non-dementia group, respectively ().P = .001).
After adjusting for covariates, the history of hypothyroidism was associated with an 81% increased risk of being diagnosed with dementia among participants aged 65 years and older (adjusted odds ratio). [aOR]1.81; 95% CI, 1.14- 2.87; P = .01). This association was not seen in patients between the ages of 50 and 65.
There was also no significant association between hyperthyroidism and dementia. In addition, patients aged 65 years and older who developed hypothyroidism after treatment for hyperthyroidism did not have a statistically significant increased risk of developing dementia.
When researchers conducted a subgroup analysis of patients aged 65 years and older, the association between dementia and thyroid disorders was the most important of the hypothyroid patients who were taking hypothyroid medication. Found to be (aOR, 3.17; 95% CI, 1.04-9.69; P = .043) People with hypothyroidism No I am taking medicine for their condition.
Weng suggested that this finding “may be due to the fact that these patients have more severe thyroid disorders and are less likely to be associated.” [side effects of] The medicine itself. “
The limitation of the study was that the researchers “could not obtain test data for each patient and the severity of thyroid disease,” Weng said.However, participants who took the following thyroid drugs Levothyroxine “It was more likely to be more severe hypothyroidism or symptomatic,” he said.
“Because the biological and molecular pathways behind this association are similar between ethnicities / races, the findings from our extensive study provide solid evidence in the literature, perhaps non-Asians. Can be generalized to, “Weng said.
However, he said the study was observational and “hence, it does not prove that hypothyroidism causes dementia, but only that it is relevant.”
Need a timely introduction
comment Medscape Medical News, Chi-Ying (Roy) Lin, MD, MPH, Associate Professor of Neurology, Alzheimer’s disease When Parkinson’s disease The Center for Baylor College of Medicine in Houston, Texas, said this was an “excellent study” that provided additional evidence for the relationship between hypothyroidism and dementia “especially from a generalization perspective.”
Lin, who was not involved in the study, said the study population consisted of Taiwanese individuals and “closed the gap that most of the current study was conducted in populations other than East Asia.” ..
“Practical clinicians need to actively test thyroid function when assessing people with cognitive symptoms,” he said.
Lynn also recommended that he be referred to an endocrinologist in a timely manner “when ambiguous results occur so as not to miss a treatment opportunity.”
This study is not targeted and funded. Weng, other investigators, and Lynn have not reported any relevant financial relationships.
Neurology. Published online on July 6, 2022. Overview
Batya Swift Yasgur, MA, LSW are freelance writers counseling in Teaneck, NJ. She regularly contributes to many medical publications, including Medscape and WebMD, including several consumer health books and Behind the Burqa: Our Livesin Afghanistan and How We Escaped to Freedom. He is also the author of (Memoirs). She was the sister who told her about them).
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