A study of thyroid dysfunction among elderly in a tertiary care hospital
Keywords::Sub clinical hypothyroidism, thyroid function test, geriatric population, dyslipidemia
Introduction and Aim: The prevalence of thyroid disorders all over the world is on the rise. However, the diagnosis is complicated among the elderlies due to factors such as non-specific clinical manifestations and interacting medications. The aim of the study is to estimate the prevalence and type of thyroid dysfunction among the elderly.
Materials and Methods: The cross-sectional study was undertaken in the Department of General Medicine of a tertiary care teachinghospital. The study included 100 subjects aged above 60 years, of both genders. Data for clinical examination and biochemical tests such as T3, T4, TSH and lipid profile were collected. Reports of USG/FNAC, performed in cases of thyroid nodule, were also checked.
Results:The prevalence of thyroid disorders was 22% of the study population. Overt and subclinical hypothyroidism were observed among 4% and 17% respectively, with 1% having hyperthyroidism. Subclinical hypothyroidism was more common among women. No specific trend was observed with increasing age.TPO antibodies were positive among 73% of the cases. Patients with thyroid dysfunction had higher values of triglycerides, total cholesterol and LDL. The proportion of dyslipidemia was significantly higher among elderly with thyroid dysfunction as compared to people with no thyroid dysfunction (90.90% Vs 24.35%, P value < 0.001).
Conclusion: Thyroid dysfunction in the elderly is common. Strong clinical suspicion of thyroid diseases in elderly patients presenting with non-specific symptoms is needed. This would aid in the diagnosis of thyroid disorders among the elderly.
Cire, B. World’s older population grows dramatically [Internet]. Maryland: National Institutes of Health; 2016 [updated 2016/03/28/; cited 2019 Sep 10]. Available from: https://www.nih.gov/news-events/news-releases/worlds-older-population-grows-dramatically.
Talwalkar, P., Deshmukh,V., Bhole, M. Prevalence of hypothyroidism in patients with type 2 diabetes mellitus and hypertension in India: a cross-sectional observational study. Diabetes Metab Syndr Obes. 2019;12:369-376.
Gesing, A., Lewi?ski, A., Karbownik-Lewi?ska, M. The thyroid gland and the process of aging; what is new? Thyroid Res. 2012;5(1):16.
Boelaert, K. Thyroid dysfunction in the elderly. Nat Rev Endocrinol. 2013;9(4):194-204.
Diez, J.J., Iglesias, P. Spontaneous subclinical hypothyroidism in patients older than 55 years: an analysis of natural course and risk factors for the development of overt thyroid failure. J Clin Endocrinol Metab. 2004;89(10):4890-4897.
Kumar, H., Singh, V., Meena, B., Gaur, S., Singla, R., Sisodiya, M. Clinical profile of thyroid dysfunction in elderly: An overview. Thyroid Research and Practice. 2016;13(3):101.
Ajish, T.P., Jayakumar, R.V. Geriatric thyroidology: An update. Indian J Endocrinol Metab. 2012;16(4):542-547.
Unnikrishnan, A.G., Kalra, S., Sahay, R.K., Bantwal, G., John, M., Tewari, N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian J Endocrinol Metab. 2013;17(4):647-652.
Iglesias, P., Munoz, A., Prado, F., Guerrero, M.T., Macias, M.C., Ridruejo, E., et al., Alterations in thyroid function tests in aged hospitalized patients: prevalence, aetiology and clinical outcome. Clin Endocrinol (Oxf). 2009;70(6):961-967.
Cappola, A.R., Fried, L.P., Arnold, A.M., Danese, M.D., Kuller, L.H., Burke, G.L., et al., Thyroid status, cardiovascular risk, and mortality in older adults. JAMA. 2006;295(9):1033-1041.
Chuo, A.M., Lim, J.K. Thyroid dysfunction in elderly patients. Ann Acad Med Singapore. 2003;32(1):96-100.
Hollowell, J.G., Staehling, N.W., Flanders, W.D., Hannon, W.H., Gunter, E.W., Spencer, C.A., et al.,Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87(2):489-499.
Bauer, M., Glenn, T., Pilhatsch, M., Pfennig, A., Whybrow, P.C. Gender differences in thyroid system function: relevance to bipolar disorder and its treatment. Bipolar Disord. 2014;16(1):58-71.
Manole, D., Schildknecht, B., Gosnell, B., Adams, E., Derwahl, M. Estrogen promotes growth of human thyroid tumor cells by different molecular mechanisms. J Clin Endocrinol Metab. 2001;86(3):1072-1077.
Compton, W.M., Conway, K.P., Stinson, F.S., Grant, B.F. Changes in the prevalence of major depression and comorbid substance use disorders in the United States between 1991-1992 and 2001-2002. Am J Psychiatry. 2006;163(12):2141-2147.
Pearce, E.N. Hypothyroidism and dyslipidemia: modern concepts and approaches. Curr Cardiol Rep. 2004;6(6):451-456.
Razvi, S., Ingoe, L., Keeka, G., Oates, C., McMillan, C., Weaver, J.U. The beneficial effect of L-thyroxine on cardiovascular risk factors, endothelial function, and quality of life in subclinical hypothyroidism: randomized, crossover trial. J Clin Endocrinol Metab. 2007;92(5):1715-1723.
Alamdari, S., Amouzegar, A., Tohidi, M., Gharibzadeh, S., Kheirkhah, P., Kheirkhah, P., et al., Hypothyroidism and Lipid Levels in a Community Based Study (TTS). Int J Endocrinol Metab. 2016;14(1):e22827.
Guntaka, M., Hanmayyagari, B., Rosaline, M., Nagesh, V. Lipid profile in subclinical hypothyroidism: A biochemical study from tertiary care hospital. CHRISMED Journal of Health and Research. 2014;1(4):266-270.
Jayasingh, I., Puthuran, P. Subclinical hypothyroidism and the risk of hypercholesterolemia. Journal of Family Medicine and Primary Care. 2016;5(4):809-816.
Flatau, E., Trougouboff, P., Kaufman, N., Reichman, N., Luboshitzky, R. Prevalence of hypothyroidism and diabetes mellitus in elderly kibbutz members. Eur J Epidemiol. 2000;16(1):43-46.
Gussekloo, J., van Exel, E., de Craen, A.J., Meinders, A.E., Frölich, M., Westendorp, R.G. Thyroid status, disability and cognitive function, and survival in old age. Jama. 2004;292(21):2591-2599.
Wilson, S., Parle, J.V., Roberts, L.M., Roalfe, A.K., Hobbs, F.D., Clark, P., et al., Prevalence of subclinical thyroid dysfunction and its relation to socioeconomic deprivation in the elderly: a community-based cross-sectional survey. J Clin Endocrinol Metab. 2006;91(12):4809-4816.
How to Cite
This work is licensed under a Creative Commons Attribution 4.0 International License.