Revised Manuscript Thyroid and Cognition 2016 07 05_DS_CA.pdf (676.59 kB)
Subclinical thyroid dysfunction and the risk of cognitive decline: a meta-analysis of prospective cohort studies
journal contribution
posted on 2017-01-06, 09:57 authored by Carole Rieben, Daniel Segna, Bruno R. da Costa, Tinh-Hai Collet, Layal Chaker, Carole E. Aubert, Christine Baumgartner, Osvaldo P. Almeida, Eef HogervorstEef Hogervorst, Stella Trompet, Kamal Masaki, Simon P. Mooijaart, Jacobijn Gussekloo, Robin P. Peeters, Douglas C. Bauer, Drahomir Aujesky, Nicolas RodondiContext: Although both overt hyper- and hypothyroidism are known to lead to cognitive impairment,
data on the association between subclinical thyroid dysfunction and cognitive function are
conflicting.
Objective: This study sought to determine the risk of dementia and cognitive decline associated
with subclinical thyroid dysfunction among prospective cohorts.
Data Sources: We searched in MEDLINE and EMBASE from inception until November 2014.
Study Selection: Two physicians identified prospective cohorts that assessed thyroid function and
cognitive outcomes (dementia; Mini-Mental State Examination [MMSE]).
Data Extraction: Data were extracted by one reviewer following standardized protocols and verified
by a second reviewer. The primary outcome was dementia and decline in cognitive function
was the secondary outcome.
Data Synthesis: Eleven prospective cohorts followed 16,805 participants during a median followup
of 44.4 months. Five studies analyzed the risk of dementia in subclinical hyperthyroidism (SHyper)
(n 6410), six in subclinical hypothyroidism (SHypo) (n 7401). Five studies analyzedMMSE decline
in SHyper (n 7895), seven in SHypo (n 8960). In random-effects models, the pooled adjusted
risk ratio for dementia in SHyper was 1.67 (95% confidence interval, 1.04; 2.69) and 1.14 (95%
confidence interval, 0.84; 1.55) in SHypo vs euthyroidism, both without evidence of significant
heterogeneity (I2 0.0%). The pooled mean MMSE decline from baseline to followup (mean 32 mo)
did not significantly differ between SHyper or SHypo vs euthyroidism.
Conclusions: SHyper might be associated with an elevated risk for dementia, whereas SHypo is not,
and both conditions are not associated with faster decline in MMSE over time. Available data are
limited, and additional large, high-quality studies are needed.
Funding
N.R.’s work is supported by a grant from the Swiss National Science Foundation (SNSF 320030-150025). T.-H.C.’s research is supported by grants from the Swiss National Science Foundation (PBLAP3-145870, P3SMP3-155318).
History
School
- Sport, Exercise and Health Sciences
Published in
The Journal of Clinical Endocrinology & MetabolismVolume
101Issue
12Pages
4945 - 4954Citation
RIEBEN, C. ... et al., 2016. Subclinical thyroid dysfunction and the risk of cognitive decline: a meta-analysis of prospective cohort studies. The Journal of Clinical Endocrinology & Metabolism, 101 (12), pp.4945-4954.Publisher
© the Endocrine SocietyVersion
- AM (Accepted Manuscript)
Publisher statement
This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/Acceptance date
2016-09-26Publication date
2016-09-30Notes
This article was published in the Journal of Clinical Endocrinology and Metabolism [© Endocrine Society] and the definitive version is available at: https://doi.org/10.1210/jc.2016-2129ISSN
0021-972XeISSN
1945-7197Publisher version
Language
- en