Excess thyroid hormone linked to cognitive disorders in older people

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Researchers from Johns Hopkins Medicine have uncovered a significant association between thyrotoxicosis—excessive thyroid hormone levels—and an increased risk of cognitive disorders in older adults.

This condition can arise from both exogenous sources, such as taking thyroid medication, and endogenous sources like hyperthyroidism and Graves’ disease.

Thyroid hormones are critical for regulating metabolic processes but having too much can lead to complications, including cognitive issues.

Although previous studies suggested a potential link between elevated thyroid hormone levels and cognitive decline, they often overlooked exogenous thyrotoxicosis, leaving some questions unanswered.

To fill these gaps, the Johns Hopkins team conducted an extensive analysis of electronic health records from 65,931 individuals aged 65 and above, all of whom were patients within their health system from 2014 to 2023.

The researchers found that all forms of thyrotoxicosis were connected to a 39% increase in the risk of developing cognitive disorders.

Age-specific findings were particularly stark. By age 75, 11% of those with thyrotoxicosis had been diagnosed with a cognitive disorder, in contrast to 6.4% without the condition.

The disparity grew with age; by 85, the figures rose to 34% for thyrotoxicosis patients versus 26% for those without.

Further analysis showed that the risk of cognitive issues varied with the severity of thyroid hormone excess. Patients experiencing significant thyroid hormone surpluses had a 65% greater risk of cognitive disorders, while those with moderate surpluses faced a 23% higher risk.

These findings underscore the need for cautious thyroid hormone therapy, especially in older patients, to prevent overtreatment that could lead to cognitive complications. Physicians are encouraged to adhere to age-appropriate treatment guidelines to reduce these risks.

The study, now published in JAMA Internal Medicine, not only highlights the critical cognitive effects of thyroid hormone levels in older adults but also offers essential guidance for healthcare providers in managing thyroid conditions more effectively.

Further investigations are necessary to delve deeper into this relationship and to refine treatment strategies, ensuring better health outcomes for older adults managing thyroid-related health issues.

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