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Serum Thyroid Function, Mortality and Disability in Advanced Old Age: The Newcastle 85+ Study.
Simon H S Pearce1, Salman Razvi1, Mohammad E Yadegarfar1
1Institute of Genetic Medicine (S.H.S.P., S.R.), Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom; Institute of Health and Society (M.E.Y., C.M.-R., A.K., J.C., T.B.K., C.J.), Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom; and Department of Internal Medicine (T.J.V.), Erasmus Medical Center, Rotterdam, The Netherlands.
Thyroid hormone levels in 85-year-olds did not significantly impact survival but did predict disability. Higher thyroid-stimulating hormone (TSH) levels were associated with better outcomes, supporting age-specific reference ranges.
Area of Science:
- Gerontology
- Endocrinology
- Public Health
Background:
- Thyroid function perturbations are common in the elderly.
- The significance of thyroid function in very old individuals remains unclear.
Purpose of the Study:
- To investigate the correlation between thyroid hormone status and mortality/disability in 85-year-olds.
- To determine if thyroid hormone variations within reference ranges impact health outcomes.
Main Methods:
- A cohort of 643 85-year-olds was assessed for health and thyroid function.
- Participants were followed for up to 9 years for mortality and disability.
- Thyroid function tests included serum TSH, FT4, FT3, and rT3, with adjustments for confounders.
Main Results:
- All-cause mortality was associated with serum rT3 and FT3, but only rT3 remained significant after adjustments.
- Baseline serum TSH and rT3 predicted future disability trajectories in men and women, respectively.
- Subclinical hypothyroidism and hyperthyroidism did not significantly worsen survival over 9 years.
Conclusions:
- Thyroid function tests predict disability in the very old.
- Higher TSH levels are linked to better outcomes, suggesting a need for age-specific reference ranges.
- Reassuring findings regarding survival for those with subclinical thyroid dysfunction.
