[Thyroid diseases in old age. Clinical aspects and therapy. Part 1: Hyperthyroidism]

Area of Science:

• Geriatric Medicine
• Endocrinology

Context:

• Clinical presentation of thyroid disease varies significantly between younger and older populations.
• Symptoms in elderly patients are frequently misattributed to the natural aging process.
• Diagnostic criteria for hyperthyroidism require adjustment in geriatric patients.

Purpose:

• To highlight the diagnostic challenges of thyroid disease in older individuals.
• To emphasize the atypical clinical manifestations of hyperthyroidism in the elderly.
• To discuss appropriate therapeutic strategies, including radioiodotherapy.

Summary:

• Older adults exhibit distinct clinical signs of thyroid disease, often presenting with organic symptoms like weight loss, asthenia, and cardiac issues, rather than classic hyperthyroid indicators.
• These symptoms are commonly misdiagnosed as age-related changes, complicating accurate diagnosis.
• Apathetic hyperthyroidism is a specific, often misinterpreted, manifestation in the elderly.
• Solitary or multilocular adenomas contribute to diagnostic difficulties, with prevalence increasing with age.

Impact:

• Improved recognition of atypical thyroid disease symptoms in the elderly.
• Enhanced diagnostic accuracy for hyperthyroidism in geriatric populations.
• Guidance on the appropriate use of radioiodotherapy for elderly patients with hyperthyroidism.