Hallab Asma
Psychiatry Neuroimaging Laboratory, Psychiatry and Radiology Departments, Mass General Brigham, Harvard Medical School, Boston, MA, USA.
Biologie Intégrative et Physiologie, Parcours Neurosciences Cellulaires et integrées, Faculté des Sciences et Ingénierie, Sorbonne Université, Paris, France.
Arch Gerontol Geriatr Plus. 2025 Sep;2(3). doi: 10.1016/j.aggp.2025.100195. Epub 2025 Aug 6.
Understanding the particularities of thyroid-cognition interactions in older adults is crucial in assessing the risks and evaluating therapeutic options.
Cross-sectional analyses where participants from Alzheimer's Disease Neuroimaging Initiative (ADNI) with mild cognitive impairment (MCI) and healthy controls (HC), with complete neurocognitive tests, thyroid stimulating hormone (TSH) 10 μIU/mL, and geriatric depression scale (GDS) 5, were eligible. Linear and logistic regression models, including testing for non-linearity, were performed. Sex strata were explored.
Of the total 1845 multiethnic US-participants, with a median age of 73 (IQR: 68, 78); 887 (48 %) were females, and 1056 (57 %) had MCI. The median TSH level was 1.70 μIU/mL (IQR: 1.15, 2.40); significantly lower in MCI than HC (1.66 vs. 1.74 μIU/mL, -value=0.02). There was a significant association between TSH and overall cognition only in males (adj. =-0.40[-0.74, -0.07], -value=0.019). The odds of being diagnosed with MCI at baseline decreased with higher TSH levels in the total study population (adj. OR=0.87[0.79 0.95], -value=0.002) and in males (adj. OR=0.80[0.70, 0.92], -value=0.001).
There was a sex-specific, statistically significant association between TSH levels and cognition in multiethnic middle-aged and older ADNI adults. Lower TSH levels and worse global cognition were statistically associated only in males. To precisely delineate the chronological onset of these disorders, longitudinal clinical studies are needed.
了解老年人甲状腺与认知相互作用的特殊性对于评估风险和评估治疗方案至关重要。
进行横断面分析，纳入来自阿尔茨海默病神经影像学倡议（ADNI）的轻度认知障碍（MCI）参与者和健康对照（HC），要求其完成全面的神经认知测试、促甲状腺激素（TSH）≤10 μIU/mL且老年抑郁量表（GDS）≤5。进行线性和逻辑回归模型分析，包括非线性检验，并对性别分层进行探索。
在美国的1845名多民族参与者中，年龄中位数为73岁（四分位间距：68, 78）；887名（48%）为女性，1056名（57%）患有MCI。TSH水平中位数为1.70 μIU/mL（四分位间距：1.15, 2.40）；MCI患者的TSH水平显著低于HC（1.66 vs. 1.74 μIU/mL，P值 = 0.02）。仅在男性中，TSH与整体认知之间存在显著关联（调整后β = -0.40[-0.74, -0.07]，P值 = 0.019）。在整个研究人群中（调整后OR = 0.87[0.79, 0.95]，P值 = 0.002）以及男性中（调整后OR = 0.80[0.70, 0.92]，P值 = 0.001），基线时被诊断为MCI的几率随TSH水平升高而降低。
在多民族的中年及老年ADNI成年人中，TSH水平与认知之间存在性别特异性的、具有统计学意义的关联。较低的TSH水平与较差的整体认知仅在男性中存在统计学关联。为了精确描述这些疾病的发病时间顺序，需要进行纵向临床研究。
