Thyrotoxicosis, a condition characterized by excess thyroid hormone in the body, has been associated with an increased risk of cognitive disorders in older adults, according to a recent study conducted by Johns Hopkins Medicine.
This study sheds light on the potential cognitive consequences of both exogenous thyrotoxicosis, caused by ingesting thyroid medication, and endogenous thyrotoxicosis, resulting from thyroid disorders like hyperthyroidism and Graves’ disease.
Thyroid Hormone and Cognitive Disorders
Thyroid hormone plays a crucial role in regulating various bodily functions, including metabolism. However, excessive levels of thyroid hormone, known as thyrotoxicosis, can lead to health complications.
Previous research hinted at a potential connection between thyrotoxicosis and cognitive disorders, but the evidence was inconclusive. Furthermore, studies often excluded exogenous thyrotoxicosis from their investigations.
To address these gaps in knowledge, the research team at Johns Hopkins Medicine conducted a comprehensive study.
They analyzed data from electronic health records of 65,931 participants aged 65 and older who received primary care within the Johns Hopkins Health System between 2014 and 2023.
The average age at the first recorded primary care visit was 71, with all patients having at least two visits spaced 30 or more days apart.
The study’s results indicated a 39% increased risk of cognitive disorder diagnosis associated with all-cause thyrotoxicosis, encompassing both endogenous and exogenous forms, across different age groups.
By age 75, 11% of patients with thyrotoxicosis had received a cognitive disorder diagnosis, compared to 6.4% of those without thyrotoxicosis.
By age 85, this gap had widened, with 34% of thyrotoxicosis patients diagnosed with a cognitive disorder, compared to 26% of those without thyrotoxicosis.
Furthermore, the study revealed a correlation between the degree of cognitive disorder risk and the level of exposure to thyroid hormone among patients prescribed thyroid hormone.
Patients with more severe excess thyroid hormone had a 65% higher risk of cognitive disorder, while those with a moderate excess had a 23% higher risk.
Implications and Recommendations
These findings suggest that the excessive thyroid hormone, often a consequence of thyroid hormone therapy, can increase the risk of cognitive disorders in older adults.
Clinicians should exercise caution when prescribing thyroid hormone therapy, particularly in older patients, to avoid overtreatment. Tailoring treatment strategies to age-appropriate guidelines can help mitigate this risk and improve patient outcomes.
In summary, this study underscores the importance of understanding the potential cognitive effects of thyroid hormone levels in older adults and provides valuable insights for healthcare professionals in managing thyroid-related conditions.
Further research is needed to explore the intricacies of this relationship and refine treatment approaches.
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The research findings can be found in JAMA Internal Medicine.
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