[Prevalence of thyroid gland dysfunctions in 50- to 80-year-old patients. An epidemiologic cross-sectional study in a southwestern community].

BACKGROUND: Thyroid dysfunctions in the elderly are common in iodine deficient Germany. However, the exact prevalence of hypo- and hyperthyroidism is unknown and differs according to the composition of the screened population. In this study we examined the prevalence of thyroid disorders in a population based sample of non-hospitalized elderly people living in a community in southwestern Germany. PATIENTS AND METHODS: In the context of an epidemiological study on the prevalence of osteoporosis and associated factors, 288 men and 271 women between the age of 50 and 80 years were screened for plasma levels of thyreotropin, free T3 and free T4. Participants received an interview on medical conditions including a history on thyroid disorders.
RESULTS: 6.7% of the women and 1.7% of the men had a history of thyroid surgery. Manifest or treated hyperthyroidism was observed in 3.5% of the women (n = 10) and 0.7% of the men (n = 2). In 2 of 12 patients with manifest hyperthyroidism the condition was previously unknown. 70- to 80-year old women tended to have a higher prevalence of hyperthyroidism (6.3%) than 50- to 59-year old women (2.9%), or 60- to 69-year old women (3.4%). Subclinical hyperthyroidism was observed in 7.3% of the men (n = 21) and 5.9% of the women (n = 16). We observed no cases of over hypothyroidism in men but in 1.8% of the women (n = 5). Four of 5 manifest states of hypothyroidism were previously unknown.
CONCLUSION: The prevalence of thyroid dysfunction in older women and men living in southwestern Germany is high. In view of the often nonspecific clinical symptoms of hypo- and hyperthyroidism in elderly individuals, thyroid disorders should be early included to the list of the differential diagnosis of clinical complaints in this age group.