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[Screening for thyroid disease. Occurrence of hypothyroidism and hyperthyroidism in patients admitted to a geriatric
1Geriatrisk afdeling B, Amtssygehuset i Glostrup.
Introduction:
The aim of this study was to evaluate whether screening of all geriatric patients for thyroid disorders should be recommended and to assess the prevalence of thyroid dysfunction in a geriatric population.
Material And Methods:
From 1 April 1997 to 31 March 1998, all patients above 60 years of age admitted to the ward of geriatric medicine at Copenhagen University Hospital, Glostrup were screened for thyroid disease with a sensitive TSH assay.
Results:
Of 480 patients with no former history of thyroid disease, three (0.6%) were found to have hypothyroidism (elevated TSH and free T4 below normal) and started treatment with Eltroxin. Twenty-three patients (4.8%) had elevated TSH with normal values of T3 and free T4 (subclinical hypothyroidism). Forty-nine patients (10.2%) had TSH values below normal with normal T3 and free T4 (subclinical hyperthyroidism). Four patients (0.8%) had TSH values below normal and elevated T3 and/or free T4 and isotope uptake studies showed multinodular goitre. None of these patients was treated. Of the 34 patients (6.2%) with known thyroid dysfunction ten patients had their treatment adjusted and two patients started treatment.
Discussion:
We found that less than 1% of the patients had an unrecognised thyroid disease that required treatment. The total prevalence of thyroid dysfunction was 7.2%. One third of the patients with a known thyroid disease needed their treatment adjusted. We would not recommend screening for thyroid dysfunction of all geriatric patients, but we would advocate better monitoring of patients already in treatment.