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Published on: February 14, 2014
Changes in Serum Thyroid Function Predict Cognitive Decline in the Very Old: Longitudinal Findings from the Newcastle
Earn H Gan1,2, Carol Jagger3, Mohammad E Yadegarfar4
1Translational and Clinical Research Institute, International Centre for Life, Newcastle University, Newcastle upon Tyne, United Kingdom.
Summary
Declining thyroid-stimulating hormone (TSH) levels in 85-year-olds correlate with reduced thyroid hormones and increased cognitive impairment risk. This TSH decline trajectory predicts future cognitive decline in older adults.
Area of Science:
- Gerontology
- Endocrinology
- Neuroscience
Background:
- Low serum thyrotropin (TSH) is linked to cognitive impairment in older adults, but the underlying mechanisms remain unclear.
- Investigating the relationship between thyroid status changes and cognitive decline in the very elderly is crucial for understanding aging-related cognitive changes.
Purpose of the Study:
- To examine the association between changes in thyroid function (TSH, fT4, fT3) and cognitive impairment in 85-year-olds over a 3-year period.
- To determine if thyroid status changes predict cognitive decline and identify potential biomarkers for cognitive impairment in later life.
Main Methods:
- Prospective cohort study of 642 individuals aged 85 with normal thyroid hormones, assessing health and thyroid function.
- Cognitive performance measured using Mini-Mental State Examination (MMSE) and Cognitive Drug Research battery.
- Statistical analysis using linear mixed, logistic regression, and Cox proportional hazard models to evaluate changes in TSH, fT4, and fT3 in relation to cognitive outcomes.
Main Results:
- A 3-year decline in serum TSH was associated with decreased free thyroxine (fT4) and free triiodothyronine (fT3) levels.
- Declining TSH trajectory increased the risk of incident cognitive impairment by 5 years (OR 1.77).
- Greater reductions in MMSE scores correlated with larger TSH declines at 3 and 5 years.
Conclusions:
- Contrary to expectations, declining TSH in 85-year-olds was linked to reduced free thyroid hormones.
- A decreasing serum TSH trajectory serves as a predictor of cognitive decline in advanced age.
- Serum TSH decline is a potential biomarker for identifying cognitive impairment in later life.
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