Does low-normal serum TSH level adversely impact cognition in elderly adults and might methimazole therapy improve outcomes?
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 investiga...
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| Veröffentlicht in: | ENDOCRINE JOURNAL 2016, Vol.63(5), pp.495-505 |
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| creator | Dhiãnah Santini de Oliveira Chachamovitz Vigário, Patrícia dos Santos Silva, Silvana Oliveira e Letícia B. B. de Mello Teixeira Fagundes, Michele Lopes Vaisman, Mário Patrícia de F. dos S. Teixeira |
| description | 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 ( |
| doi_str_mv | 10.1507/endocrj.EJ15-0458 |
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B. de Mello Teixeira ; Fagundes, Michele Lopes ; Vaisman, Mário ; Patrícia de F. dos S. Teixeira</creator><creatorcontrib>Dhiãnah Santini de Oliveira Chachamovitz ; Vigário, Patrícia dos Santos ; Silva, Silvana Oliveira e ; Letícia B. B. de Mello Teixeira ; Fagundes, Michele Lopes ; Vaisman, Mário ; Patrícia de F. dos S. Teixeira ; Augusto Motta University Center (UNISUAM ; Physical Education and Sports School ; Federal University of Rio de Janeiro ; Estacio de Sa University ; Ergospirometry and Kinanthropometry Laboratory ; Medicine School - Federal University of Rio de Janeiro ; Postgraduate Program of Rehabilitation Sciences</creatorcontrib><description>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.</description><identifier>ISSN: 0918-8959</identifier><identifier>EISSN: 1348-4540</identifier><identifier>DOI: 10.1507/endocrj.EJ15-0458</identifier><identifier>PMID: 27052122</identifier><language>eng</language><publisher>Japan: The Japan Endocrine Society</publisher><subject>Aged ; Aged, 80 and over ; Aging - blood ; Cognition ; Cognition - drug effects ; Cognition Disorders - blood ; Cognition Disorders - drug therapy ; Cross-Sectional Studies ; Depression ; Depression - blood ; Elderly ; Female ; Geriatric Assessment ; Humans ; Longitudinal Studies ; Male ; Methimazole - therapeutic use ; Pilot Projects ; Reference Values ; Thyroid Function Tests - standards ; Thyrotropin - blood ; TSH</subject><ispartof>Endocrine Journal, 2016, Vol.63(5), pp.495-505</ispartof><rights>The Japan Endocrine Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c711t-12ecfc936d9fba36de38f24ddcc39f1f0a75455abf8a092b0b31594b32a6df7e3</citedby><cites>FETCH-LOGICAL-c711t-12ecfc936d9fba36de38f24ddcc39f1f0a75455abf8a092b0b31594b32a6df7e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27052122$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dhiãnah Santini de Oliveira Chachamovitz</creatorcontrib><creatorcontrib>Vigário, Patrícia dos Santos</creatorcontrib><creatorcontrib>Silva, Silvana Oliveira e</creatorcontrib><creatorcontrib>Letícia B. B. de Mello Teixeira</creatorcontrib><creatorcontrib>Fagundes, Michele Lopes</creatorcontrib><creatorcontrib>Vaisman, Mário</creatorcontrib><creatorcontrib>Patrícia de F. dos S. Teixeira</creatorcontrib><creatorcontrib>Augusto Motta University Center (UNISUAM</creatorcontrib><creatorcontrib>Physical Education and Sports School</creatorcontrib><creatorcontrib>Federal University of Rio de Janeiro</creatorcontrib><creatorcontrib>Estacio de Sa University</creatorcontrib><creatorcontrib>Ergospirometry and Kinanthropometry Laboratory</creatorcontrib><creatorcontrib>Medicine School - Federal University of Rio de Janeiro</creatorcontrib><creatorcontrib>Postgraduate Program of Rehabilitation Sciences</creatorcontrib><title>Does low-normal serum TSH level adversely impact cognition in elderly adults and might methimazole therapy improve outcomes?</title><title>ENDOCRINE JOURNAL</title><addtitle>Endocr J</addtitle><description>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.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging - blood</subject><subject>Cognition</subject><subject>Cognition - drug effects</subject><subject>Cognition Disorders - blood</subject><subject>Cognition Disorders - drug therapy</subject><subject>Cross-Sectional Studies</subject><subject>Depression</subject><subject>Depression - blood</subject><subject>Elderly</subject><subject>Female</subject><subject>Geriatric Assessment</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Methimazole - therapeutic use</subject><subject>Pilot Projects</subject><subject>Reference Values</subject><subject>Thyroid Function Tests - standards</subject><subject>Thyrotropin - blood</subject><subject>TSH</subject><issn>0918-8959</issn><issn>1348-4540</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkEFv1DAQhS0EokvhB3BBPnJJa8dxEp8QKqUFVeJAOVuOPdn1yrG3trOoiB-Pt7sNF4-lefO9mYfQe0ouKCfdJXgTdNxeXH-nvCIN71-gFWVNXzW8IS_RigjaV73g4gy9SWlLCGO8Ya_RWd0RXtO6XqG_XwIk7MLvyoc4KYcTxHnC9z9vsYM9OKzMHmIC94jttFM6Yx3W3mYbPLYegzMQS0-Z2eWElTd4sutNxhPkjZ3Un-AA5w1EtXsCxLAHHOaswwTp01v0alQuwbtTPUe_vl7fX91Wdz9uvl19vqt0R2muaA161IK1RoyDKgVYP9aNMVozMdKRqI43nKth7BUR9UAGRrloBlar1owdsHP08cgt_g8zpCwnmzQ4pzyEOUnaCSYIL9EVKT1KdQwpRRjlLpY74qOkRB5Cl6fQ5SF0eQi9zHw44edhArNMPKdcBDdHQelarVzwznqQ2zBHX-6W-qF9osqa0FYS0jJS0MWQNKJ8eMG0Xdez_j9pm7Jaw2KlYrbawbJcyyQ_PMuSi0JvVCwy9g8MorKI</recordid><startdate>2016</startdate><enddate>2016</enddate><creator>Dhiãnah Santini de Oliveira Chachamovitz</creator><creator>Vigário, Patrícia dos Santos</creator><creator>Silva, Silvana Oliveira e</creator><creator>Letícia B. B. de Mello Teixeira</creator><creator>Fagundes, Michele Lopes</creator><creator>Vaisman, Mário</creator><creator>Patrícia de F. dos S. Teixeira</creator><general>The Japan Endocrine Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2016</creationdate><title>Does low-normal serum TSH level adversely impact cognition in elderly adults and might methimazole therapy improve outcomes?</title><author>Dhiãnah Santini de Oliveira Chachamovitz ; Vigário, Patrícia dos Santos ; Silva, Silvana Oliveira e ; Letícia B. B. de Mello Teixeira ; Fagundes, Michele Lopes ; Vaisman, Mário ; Patrícia de F. dos S. Teixeira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c711t-12ecfc936d9fba36de38f24ddcc39f1f0a75455abf8a092b0b31594b32a6df7e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging - blood</topic><topic>Cognition</topic><topic>Cognition - drug effects</topic><topic>Cognition Disorders - blood</topic><topic>Cognition Disorders - drug therapy</topic><topic>Cross-Sectional Studies</topic><topic>Depression</topic><topic>Depression - blood</topic><topic>Elderly</topic><topic>Female</topic><topic>Geriatric Assessment</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Methimazole - therapeutic use</topic><topic>Pilot Projects</topic><topic>Reference Values</topic><topic>Thyroid Function Tests - standards</topic><topic>Thyrotropin - blood</topic><topic>TSH</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dhiãnah Santini de Oliveira Chachamovitz</creatorcontrib><creatorcontrib>Vigário, Patrícia dos Santos</creatorcontrib><creatorcontrib>Silva, Silvana Oliveira e</creatorcontrib><creatorcontrib>Letícia B. B. de Mello Teixeira</creatorcontrib><creatorcontrib>Fagundes, Michele Lopes</creatorcontrib><creatorcontrib>Vaisman, Mário</creatorcontrib><creatorcontrib>Patrícia de F. dos S. Teixeira</creatorcontrib><creatorcontrib>Augusto Motta University Center (UNISUAM</creatorcontrib><creatorcontrib>Physical Education and Sports School</creatorcontrib><creatorcontrib>Federal University of Rio de Janeiro</creatorcontrib><creatorcontrib>Estacio de Sa University</creatorcontrib><creatorcontrib>Ergospirometry and Kinanthropometry Laboratory</creatorcontrib><creatorcontrib>Medicine School - Federal University of Rio de Janeiro</creatorcontrib><creatorcontrib>Postgraduate Program of Rehabilitation Sciences</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>ENDOCRINE JOURNAL</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dhiãnah Santini de Oliveira Chachamovitz</au><au>Vigário, Patrícia dos Santos</au><au>Silva, Silvana Oliveira e</au><au>Letícia B. B. de Mello Teixeira</au><au>Fagundes, Michele Lopes</au><au>Vaisman, Mário</au><au>Patrícia de F. dos S. Teixeira</au><aucorp>Augusto Motta University Center (UNISUAM</aucorp><aucorp>Physical Education and Sports School</aucorp><aucorp>Federal University of Rio de Janeiro</aucorp><aucorp>Estacio de Sa University</aucorp><aucorp>Ergospirometry and Kinanthropometry Laboratory</aucorp><aucorp>Medicine School - Federal University of Rio de Janeiro</aucorp><aucorp>Postgraduate Program of Rehabilitation Sciences</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does low-normal serum TSH level adversely impact cognition in elderly adults and might methimazole therapy improve outcomes?</atitle><jtitle>ENDOCRINE JOURNAL</jtitle><addtitle>Endocr J</addtitle><date>2016</date><risdate>2016</risdate><volume>63</volume><issue>5</issue><spage>495</spage><epage>505</epage><pages>495-505</pages><issn>0918-8959</issn><eissn>1348-4540</eissn><abstract>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.</abstract><cop>Japan</cop><pub>The Japan Endocrine Society</pub><pmid>27052122</pmid><doi>10.1507/endocrj.EJ15-0458</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Aging - blood Cognition Cognition - drug effects Cognition Disorders - blood Cognition Disorders - drug therapy Cross-Sectional Studies Depression Depression - blood Elderly Female Geriatric Assessment Humans Longitudinal Studies Male Methimazole - therapeutic use Pilot Projects Reference Values Thyroid Function Tests - standards Thyrotropin - blood TSH |
| title | Does low-normal serum TSH level adversely impact cognition in elderly adults and might methimazole therapy improve outcomes? |
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