Herrmann J
Z Gerontol. 1984 Sep-Oct;17(5):298-301.
Hyper- and hypothyroidism in the elderly do--as many other diseases--not present with the typical clinical picture known from textbook descriptions. Thus hyperthyroidism may be the cause of common complaints and symptoms such as weight loss, fatigue, lack of appetite and cardiac failure with tachycardiac arrhythmias. Due to completely unspecific symptoms and signs, the hypothyroid elderly patient will initially be presented to a psychiatrist, neurologist, dermatologist, gastroenterologist or ENT-specialist rather than to an endocrinologist or geriatrician. The serious consequences which may result from overlooking hyper- and hypothyroidism in the elderly can be prevented if the possibility of thyroid disease is more frequently taken into consideration, if the diagnosis is based on modern in-vitro measurements, and if hyper- and hypothyroidism are systematically looked for in groups at risk, i.e. in inhabitants of old people's, homes, nursing homes as well as in patients of psychiatric and geriatric hospitals.
老年人的甲状腺功能亢进和减退与许多其他疾病一样,并不表现出教科书描述中的典型临床症状。因此,甲状腺功能亢进可能是体重减轻、疲劳、食欲不振和伴有快速心律失常的心力衰竭等常见主诉和症状的原因。由于症状和体征完全不具特异性,甲状腺功能减退的老年患者最初会被转诊至精神科医生、神经科医生、皮肤科医生、胃肠科医生或耳鼻喉科专家处,而非内分泌科医生或老年病科医生。如果更频繁地考虑甲状腺疾病的可能性,如果诊断基于现代体外检测方法,并且如果在高危人群中系统地筛查甲状腺功能亢进和减退,即在养老院、疗养院的居民以及精神病院和老年病院的患者中进行筛查,那么就可以避免因忽视老年人甲状腺功能亢进和减退而可能产生的严重后果。