Subclinical Thyroid Dysfunction and the Risk of Cognitive Decline: a Meta-Analysis of Prospective Cohort Studies.

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Version: Author's accepted manuscript
Serval ID
serval:BIB_3D1FA9D6A561
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Subclinical Thyroid Dysfunction and the Risk of Cognitive Decline: a Meta-Analysis of Prospective Cohort Studies.
Journal
The Journal of clinical endocrinology and metabolism
Author(s)
Rieben C., Segna D., da Costa B.R., Collet T.H., Chaker L., Aubert C.E., Baumgartner C., Almeida O.P., Hogervorst E., Trompet S., Masaki K., Mooijaart S.P., Gussekloo J., Peeters R.P., Bauer D.C., Aujesky D., Rodondi N.
ISSN
1945-7197 (Electronic)
ISSN-L
0021-972X
Publication state
Published
Issued date
12/2016
Peer-reviewed
Oui
Volume
101
Number
12
Pages
4945-4954
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis ; Review
Publication Status: ppublish
Abstract
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.
This study sought to determine the risk of dementia and cognitive decline associated with subclinical thyroid dysfunction among prospective cohorts.
We searched in MEDLINE and EMBASE from inception until November 2014.
Two physicians identified prospective cohorts that assessed thyroid function and cognitive outcomes (dementia; Mini-Mental State Examination [MMSE]).
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.
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 analyzed MMSE 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 (I(2) = 0.0%). The pooled mean MMSE decline from baseline to followup (mean 32 mo) did not significantly differ between SHyper or SHypo vs euthyroidism.
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.

Keywords
Cognitive Dysfunction/epidemiology, Cognitive Dysfunction/etiology, Dementia/epidemiology, Dementia/etiology, Humans, Hyperthyroidism/complications, Hyperthyroidism/epidemiology, Hypothyroidism/complications, Hypothyroidism/epidemiology
Pubmed
Web of science
Open Access
Yes
Create date
11/10/2016 16:56
Last modification date
20/08/2019 13:33
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