公衆衛生
Dvir Dori1, Bruna Seixas Lima2, Carlos Tyler Roncero2
1Rotman Research Institute-Baycrest, TORONTO, ON, Canada.
Background:
Emerging hypotheses suggest that 'suboptimal' thyroid function, defined as higher-normal TSH (2.0-4.5 µIU/ml) or low-normal FT4, may increase the risk of cognitive decline and dementia.
Method:
This study tested these claims using data from 991 participants in the COMPASS-ND cohort, aged 50-91, with cognitive statuses ranging from unimpaired to dementia. Thyroid function was classified as "optimal" (TSH<2.0 µIU/ml or FT4≥16.74 pmol/L) or "suboptimal."
Result:
Chi-square analysis of 883 participants (523 with FT4 data) found no significant association between "suboptimal" thyroid function and cognitive impairment (TSH: χ2=0.1585, p = 0.69; FT4: χ2=0.0027, p = 0.96). True hypothyroidism was rare, and 98.6% of participants with elevated TSH had normal FT4 levels.
Conclusion:
These findings refute claims that higher-normal TSH or low-normal FT4 increases cognitive decline risk, highlighting the need for caution in redefining TSH cutoffs or pursuing unproven thyroid supplementation as a cognitive health intervention.
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