Ajay K Parsaik1, Balwinder Singh2, Rosebud O Roberts3, Shane Pankratz4, Kelly K Edwards4, Yonas E Geda5, Hossein Gharib6, Bradley F Boeve7, David S Knopman7, Ronald C Petersen7. 1. Department of Psychiatry and Behavior Sciences, The University of Texas Medical School, Houston2Mayo Alzheimer's Disease Research Center, Mayo Clinic, Rochester, Minnesota3Department of Neurology, Mayo Clinic, Rochester, Minnesota. 2. Mayo Alzheimer's Disease Research Center, Mayo Clinic, Rochester, Minnesota3Department of Neurology, Mayo Clinic, Rochester, Minnesota4Department of Clinical Neuroscience, School of Medicine and Health Sciences, University of North Dakota, Fargo. 3. Department of Neurology, Mayo Clinic, Rochester, Minnesota5Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota. 4. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota. 5. Department of Psychiatry and Psychology, Mayo Clinic, Scottsdale, Arizona8Department of Neurology, Mayo Clinic, Scottsdale, Arizona. 6. Division of Endocrinology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota. 7. Mayo Alzheimer's Disease Research Center, Mayo Clinic, Rochester, Minnesota3Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Abstract
IMPORTANCE: An association of clinical and subclinical hypothyroidism with mild cognitive impairment (MCI) has not been established. OBJECTIVE: To evaluate the association of clinical and subclinical hypothyroidism with MCI in a large population-based cohort. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional, population-based study was conducted in Olmsted County, Minnesota. Randomly selected participants were aged 70 to 89 years on October 1, 2004, and were without documented prevalent dementia [CORRECTED]. A total of 2050 participants were evaluated and underwent in-person interview, neurologic evaluation, and neuropsychological testing to assess performance in memory, attention/executive function, and visuospatial and language domains. Participants were categorized by consensus as being cognitively normal, having MCI, or having dementia according to published criteria. Clinical and subclinical hypothyroidism were ascertained from a medical records linkage system. MAIN OUTCOMES AND MEASURES: Association of clinical and subclinical hypothyroidism with MCI. RESULTS: Among 1904 eligible participants, the frequency of MCI was 16% in 1450 individuals with normal thyroid function, 17% in 313 persons with clinical hypothyroidism, and 18% in 141 individuals with subclinical hypothyroidism. After adjusting for covariates (age, educational level, sex, apolipoprotein E ε4, depression, diabetes mellitus, hypertension, stroke, body mass index, and coronary artery disease) we found no significant association between clinical or subclinical hypothyroidism and MCI (odds ratio [OR], 0.99 [95% CI, 0.66-1.48] and 0.88 [0.38-2.03], respectively). No effect of sex interaction was seen on these effects. In stratified analysis, the odds of MCI with clinical and subclinical hypothyroidism among men was 1.02 (95% CI, 0.57-1.82) and 1.29 (0.68-2.44) and, among women, was 1.04 (0.66-1.66) and 0.86 (0.37-2.02), respectively. CONCLUSIONS AND RELEVANCE: In this population-based cohort of elderly people, neither clinical nor subclinical hypothyroidism was associated with MCI. Our findings need to be validated in a separate setting using the published criteria for MCI and confirmed in a longitudinal study.
RCT Entities:
IMPORTANCE: An association of clinical and subclinical hypothyroidism with mild cognitive impairment (MCI) has not been established. OBJECTIVE: To evaluate the association of clinical and subclinical hypothyroidism with MCI in a large population-based cohort. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional, population-based study was conducted in Olmsted County, Minnesota. Randomly selected participants were aged 70 to 89 years on October 1, 2004, and were without documented prevalent dementia [CORRECTED]. A total of 2050 participants were evaluated and underwent in-person interview, neurologic evaluation, and neuropsychological testing to assess performance in memory, attention/executive function, and visuospatial and language domains. Participants were categorized by consensus as being cognitively normal, having MCI, or having dementia according to published criteria. Clinical and subclinical hypothyroidism were ascertained from a medical records linkage system. MAIN OUTCOMES AND MEASURES: Association of clinical and subclinical hypothyroidism with MCI. RESULTS: Among 1904 eligible participants, the frequency of MCI was 16% in 1450 individuals with normal thyroid function, 17% in 313 persons with clinical hypothyroidism, and 18% in 141 individuals with subclinical hypothyroidism. After adjusting for covariates (age, educational level, sex, apolipoprotein E ε4, depression, diabetes mellitus, hypertension, stroke, body mass index, and coronary artery disease) we found no significant association between clinical or subclinical hypothyroidism and MCI (odds ratio [OR], 0.99 [95% CI, 0.66-1.48] and 0.88 [0.38-2.03], respectively). No effect of sex interaction was seen on these effects. In stratified analysis, the odds of MCI with clinical and subclinical hypothyroidism among men was 1.02 (95% CI, 0.57-1.82) and 1.29 (0.68-2.44) and, among women, was 1.04 (0.66-1.66) and 0.86 (0.37-2.02), respectively. CONCLUSIONS AND RELEVANCE: In this population-based cohort of elderly people, neither clinical nor subclinical hypothyroidism was associated with MCI. Our findings need to be validated in a separate setting using the published criteria for MCI and confirmed in a longitudinal study.
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