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老年人的甲状腺功能与认知能力下降

Thyroid Functions and Cognitive Decline in the Elderly.

作者信息

Muhammad Ayaz, Ul Haq Ijaz, Khan Mehr Ali, Hassan Hafiz Syed Ahmad, Aman Bilal, Arshad Muhammad Muneeb

机构信息

Internal Medicine, Mardan Medical Complex, Medical Teaching Institution, Mardan, PAK.

Internal Medicine, Nenagh General Hospital, Tipperary, IRL.

出版信息

Cureus. 2024 Nov 26;16(11):e74484. doi: 10.7759/cureus.74484. eCollection 2024 Nov.

Abstract

Background The maintenance of cognitive health depends on thyroid hormones, and it is becoming more widely acknowledged that thyroid hormone issues may be a factor in cognitive decline in the aged. Objective This study aimed to investigate the association between thyroid hormone levels and cognitive decline among elderly individuals, considering the influence of age-related factors and comorbidities. Methodology Over the course of two years, 218 adults 60 years of age and older with clinically diagnosed hypothyroidism or subclinical thyroid disease were included in a prospective observational research. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (T4), and free triiodothyronine (T3) were measured at baseline and at 6, 12, 18, and 24-month intervals to evaluate thyroid function. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used to assess cognitive function at the same intervals. Factors linked to cognitive deterioration were identified using multivariate regression analysis. Results The study found that TSH levels decreased from 3.20 ± 1.82 µIU/mL at baseline to 2.80 ± 1.51 by 24 months (p < 0.001), while free T4 levels increased from 13.50 ± 2.53 pmol/L to 14.20 ± 2.52 pmol/L (p = 0.020). Cognitive scores declined significantly, with MMSE scores dropping from 23.27 ± 4.64 to 21.80 ± 4.89 (p = 0.005) and MoCA scores from 21.20 ± 5.11 to 20.03 ± 5.51 (p = 0.012). Conclusion The results show a strong correlation between thyroid malfunction and cognitive loss in the elderly, emphasizing the need to closely monitor thyroid function to maintain cognitive function in this population.

摘要

背景

认知健康的维持依赖于甲状腺激素,并且甲状腺激素问题可能是老年人认知衰退的一个因素这一观点正得到越来越广泛的认可。目的:本研究旨在探讨老年人甲状腺激素水平与认知衰退之间的关联,同时考虑年龄相关因素和合并症的影响。方法:在两年的时间里,218名临床诊断为甲状腺功能减退或亚临床甲状腺疾病的60岁及以上成年人被纳入一项前瞻性观察性研究。在基线以及6、12、18和24个月时测量血清促甲状腺激素(TSH)、游离甲状腺素(T4)和游离三碘甲状腺原氨酸(T3)水平,以评估甲状腺功能。在相同时间间隔使用简易精神状态检查表(MMSE)和蒙特利尔认知评估量表(MoCA)评估认知功能。使用多变量回归分析确定与认知衰退相关的因素。结果:研究发现,TSH水平从基线时的3.20±1.82µIU/mL降至24个月时的2.80±1.51(p<0.001),而游离T4水平从13.50±2.53pmol/L升至14.20±2.52pmol/L(p=0.020)。认知评分显著下降,MMSE评分从23.27±4.64降至21.80±4.89(p=0.005),MoCA评分从21.20±5.11降至20.03±5.51(p=0.012)。结论:结果表明老年人甲状腺功能障碍与认知丧失之间存在密切关联,强调需要密切监测甲状腺功能以维持该人群的认知功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5d/11670265/859346df5e4e/cureus-0016-00000074484-i01.jpg

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