甲状腺状况,残疾和认知功能,以及老年生存率
Jacobijn Gussekloo1, Eric van Exel, Anton J M de Craen
1Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands. jgussekloo@lumc.nl
JAMA
|December 2, 2004
概括
在最老的老年人中,高甲状腺激素水平与不良结果无关,并且可能延长寿命. 然而,需要随机试验来确认治疗亚临床甲状腺功能障碍是否有利于老年人.
科学领域:
- 老年学是一门学科.
- 内分泌学 在内分泌学.
- 流行病学 流行病学
背景情况:
- 临床意见往往有利于治疗老年人的亚临床甲状腺疾病,尽管试验结果混杂.
- 在晚年未经治疗的甲状腺功能障碍的长期影响仍然不清楚.
研究的目的:
- 为了研究亚临床甲状腺功能障碍对最老的老年人的表现和生存的影响.
- 为了确定老年人是否需要治疗亚临床甲状腺功能障碍.
主要方法:
- 一项基于人口的前性随访研究,对599名85岁及以上的个人进行了随访.
- 甲状腺状况,日常生活残疾,抑郁症状,认知功能和死亡率在平均3.7年的随访期间进行了评估.
主要成果:
- 甲状腺素和自由甲状腺素水平与残疾,抑郁或认知障碍无关.
- 较高的甲状腺激素水平与较低的死亡率相关 (HR,每SD增加0.77).
- 较高的自由甲状腺素水平与增加的死亡率相关 (HR,每次SD增加1.16).
结论:
- 在最老的老年人中,提升的甲状腺激素水平似乎不会引起不良影响,并且可能与更长的寿命有关.
- 来自随机对照试验的进一步证据是必要的,以指导老年人亚临床甲状腺功能障碍的治疗决策.
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