Thyroid function, activities of daily living and survival in extreme old age: the 'Leiden 85-plus Study'

J Gussekloo, E van Exel, A J M de Craen, A E Meinders, M Frölich, R G J Westendorp

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVE: To determine the relationship between differences in thyroid function, changes in the activities of daily living and survival in the extremely-old segment of the general population in order to see whether screening for and treatment of subclinical thyroid-function disorders in the elderly will have a positive effect.

DESIGN: Prospective observational population study among 85-year-olds.

METHOD: As part of the 'Leiden 85-plus Study', all persons were followed who had their 85th birthday during the period from 1 September 1997 to 31 August 1999 (average length of time followed: 3.7 years; SD: 1.4). There were 558 participants. The thyroid function of these subjects was determined and the limitations in the activities of daily living, depressive symptoms, cognitive function and mortality were recorded annually.

RESULTS: At the age of 85, there was no relation between the serum levels of thyroid-stimulating hormone (TSH) or free thyroxine (FT4) and limitations in the activities of daily living, the occurrence of depressive symptoms and cognitive deterioration. Neither was any relationship found during the period of follow-up. A higher TSH-level was associated with a lower mortality, even after correction for the differences in performance and health during the base measurement (mortality risk: 0.77 per SD-increase in TSH; 95% CI: 0.63-0.94). The mortality risk per SD-increase in FT4 was 1.16 (95% CI: 1.04-1.30).

CONCLUSION: From the age of 85, there was no relationship between thyroid function and limitations in the activities of daily living, the occurrence of depressive symptoms or a deterioration in cognitive functions. Moreover, elderly persons with a less active thyroid gland lived longer. This raises the question whether the screening for and treatment of subclinical thyroid-function disorders in persons of extreme old age, as recommended, will have any positive effects.

Translated title of the contributionThyroid function, activities of daily living and survival in extreme old age: the 'Leiden 85-plus Study'
Original languageDutch
Pages (from-to)90-6
Number of pages7
JournalNederlands Tijdschrift voor Geneeskunde
Volume150
Issue number2
Publication statusPublished - 14 Jan 2006

Cite this

Gussekloo, J., van Exel, E., de Craen, A. J. M., Meinders, A. E., Frölich, M., & Westendorp, R. G. J. (2006). Schildklierfunctie, dagelijks functioneren en overleving van de oudste ouderen; de 'Leiden 85-plus Studie'. Nederlands Tijdschrift voor Geneeskunde, 150(2), 90-6.
Gussekloo, J ; van Exel, E ; de Craen, A J M ; Meinders, A E ; Frölich, M ; Westendorp, R G J. / Schildklierfunctie, dagelijks functioneren en overleving van de oudste ouderen; de 'Leiden 85-plus Studie'. In: Nederlands Tijdschrift voor Geneeskunde. 2006 ; Vol. 150, No. 2. pp. 90-6.
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title = "Schildklierfunctie, dagelijks functioneren en overleving van de oudste ouderen; de 'Leiden 85-plus Studie'",
abstract = "OBJECTIVE: To determine the relationship between differences in thyroid function, changes in the activities of daily living and survival in the extremely-old segment of the general population in order to see whether screening for and treatment of subclinical thyroid-function disorders in the elderly will have a positive effect.DESIGN: Prospective observational population study among 85-year-olds.METHOD: As part of the 'Leiden 85-plus Study', all persons were followed who had their 85th birthday during the period from 1 September 1997 to 31 August 1999 (average length of time followed: 3.7 years; SD: 1.4). There were 558 participants. The thyroid function of these subjects was determined and the limitations in the activities of daily living, depressive symptoms, cognitive function and mortality were recorded annually.RESULTS: At the age of 85, there was no relation between the serum levels of thyroid-stimulating hormone (TSH) or free thyroxine (FT4) and limitations in the activities of daily living, the occurrence of depressive symptoms and cognitive deterioration. Neither was any relationship found during the period of follow-up. A higher TSH-level was associated with a lower mortality, even after correction for the differences in performance and health during the base measurement (mortality risk: 0.77 per SD-increase in TSH; 95{\%} CI: 0.63-0.94). The mortality risk per SD-increase in FT4 was 1.16 (95{\%} CI: 1.04-1.30).CONCLUSION: From the age of 85, there was no relationship between thyroid function and limitations in the activities of daily living, the occurrence of depressive symptoms or a deterioration in cognitive functions. Moreover, elderly persons with a less active thyroid gland lived longer. This raises the question whether the screening for and treatment of subclinical thyroid-function disorders in persons of extreme old age, as recommended, will have any positive effects.",
keywords = "Activities of Daily Living, Aged, 80 and over, Cognition Disorders/diagnosis, Depression/physiopathology, Disabled Persons, Female, Humans, Hypothyroidism/mortality, Male, Proportional Hazards Models, Prospective Studies, Survival Analysis, Thyroid Diseases/diagnosis, Thyrotropin/blood, Thyroxine/blood, Triiodothyronine/blood",
author = "J Gussekloo and {van Exel}, E and {de Craen}, {A J M} and Meinders, {A E} and M Fr{\"o}lich and Westendorp, {R G J}",
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Gussekloo, J, van Exel, E, de Craen, AJM, Meinders, AE, Frölich, M & Westendorp, RGJ 2006, 'Schildklierfunctie, dagelijks functioneren en overleving van de oudste ouderen; de 'Leiden 85-plus Studie'' Nederlands Tijdschrift voor Geneeskunde, vol. 150, no. 2, pp. 90-6.

Schildklierfunctie, dagelijks functioneren en overleving van de oudste ouderen; de 'Leiden 85-plus Studie'. / Gussekloo, J; van Exel, E; de Craen, A J M; Meinders, A E; Frölich, M; Westendorp, R G J.

In: Nederlands Tijdschrift voor Geneeskunde, Vol. 150, No. 2, 14.01.2006, p. 90-6.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Schildklierfunctie, dagelijks functioneren en overleving van de oudste ouderen; de 'Leiden 85-plus Studie'

AU - Gussekloo, J

AU - van Exel, E

AU - de Craen, A J M

AU - Meinders, A E

AU - Frölich, M

AU - Westendorp, R G J

PY - 2006/1/14

Y1 - 2006/1/14

N2 - OBJECTIVE: To determine the relationship between differences in thyroid function, changes in the activities of daily living and survival in the extremely-old segment of the general population in order to see whether screening for and treatment of subclinical thyroid-function disorders in the elderly will have a positive effect.DESIGN: Prospective observational population study among 85-year-olds.METHOD: As part of the 'Leiden 85-plus Study', all persons were followed who had their 85th birthday during the period from 1 September 1997 to 31 August 1999 (average length of time followed: 3.7 years; SD: 1.4). There were 558 participants. The thyroid function of these subjects was determined and the limitations in the activities of daily living, depressive symptoms, cognitive function and mortality were recorded annually.RESULTS: At the age of 85, there was no relation between the serum levels of thyroid-stimulating hormone (TSH) or free thyroxine (FT4) and limitations in the activities of daily living, the occurrence of depressive symptoms and cognitive deterioration. Neither was any relationship found during the period of follow-up. A higher TSH-level was associated with a lower mortality, even after correction for the differences in performance and health during the base measurement (mortality risk: 0.77 per SD-increase in TSH; 95% CI: 0.63-0.94). The mortality risk per SD-increase in FT4 was 1.16 (95% CI: 1.04-1.30).CONCLUSION: From the age of 85, there was no relationship between thyroid function and limitations in the activities of daily living, the occurrence of depressive symptoms or a deterioration in cognitive functions. Moreover, elderly persons with a less active thyroid gland lived longer. This raises the question whether the screening for and treatment of subclinical thyroid-function disorders in persons of extreme old age, as recommended, will have any positive effects.

AB - OBJECTIVE: To determine the relationship between differences in thyroid function, changes in the activities of daily living and survival in the extremely-old segment of the general population in order to see whether screening for and treatment of subclinical thyroid-function disorders in the elderly will have a positive effect.DESIGN: Prospective observational population study among 85-year-olds.METHOD: As part of the 'Leiden 85-plus Study', all persons were followed who had their 85th birthday during the period from 1 September 1997 to 31 August 1999 (average length of time followed: 3.7 years; SD: 1.4). There were 558 participants. The thyroid function of these subjects was determined and the limitations in the activities of daily living, depressive symptoms, cognitive function and mortality were recorded annually.RESULTS: At the age of 85, there was no relation between the serum levels of thyroid-stimulating hormone (TSH) or free thyroxine (FT4) and limitations in the activities of daily living, the occurrence of depressive symptoms and cognitive deterioration. Neither was any relationship found during the period of follow-up. A higher TSH-level was associated with a lower mortality, even after correction for the differences in performance and health during the base measurement (mortality risk: 0.77 per SD-increase in TSH; 95% CI: 0.63-0.94). The mortality risk per SD-increase in FT4 was 1.16 (95% CI: 1.04-1.30).CONCLUSION: From the age of 85, there was no relationship between thyroid function and limitations in the activities of daily living, the occurrence of depressive symptoms or a deterioration in cognitive functions. Moreover, elderly persons with a less active thyroid gland lived longer. This raises the question whether the screening for and treatment of subclinical thyroid-function disorders in persons of extreme old age, as recommended, will have any positive effects.

KW - Activities of Daily Living

KW - Aged, 80 and over

KW - Cognition Disorders/diagnosis

KW - Depression/physiopathology

KW - Disabled Persons

KW - Female

KW - Humans

KW - Hypothyroidism/mortality

KW - Male

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Survival Analysis

KW - Thyroid Diseases/diagnosis

KW - Thyrotropin/blood

KW - Thyroxine/blood

KW - Triiodothyronine/blood

M3 - Article

VL - 150

SP - 90

EP - 96

JO - Nederlands Tijdschrift voor Geneeskunde

JF - Nederlands Tijdschrift voor Geneeskunde

SN - 0028-2162

IS - 2

ER -