Association Between Subclinical Thyroid Dysfunction and Cognitive Decline: Findings From the ELSA-Brasil Study.

Autor:	Gomes Gonçalves N; Division of Geriatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil., Szlejf C; Center for Clinical and Epidemiological Research, Hospital Universitario, University of São Paulo, São Paulo, São Paulo, Brazil., Lotufo PA; Center for Clinical and Epidemiological Research, Hospital Universitario, University of São Paulo, São Paulo, São Paulo, Brazil., Bensenor IM; Center for Clinical and Epidemiological Research, Hospital Universitario, University of São Paulo, São Paulo, São Paulo, Brazil., Suemoto CK; Division of Geriatrics, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	The journals of gerontology. Series A, Biological sciences and medical sciences [J Gerontol A Biol Sci Med Sci] 2024 Aug 01; Vol. 79 (8).
DOI:	10.1093/gerona/glae169
Abstrakt:	Background: Thyroid dysfunction has been associated with cognitive decline and dementia. However, the role of subtle thyroid hormone alterations in cognitive function is still debatable. Methods: Participants without overt thyroid dysfunction aged 35-74 years at baseline were evaluated in 3 study waves (2008-2010, 2012-2014, and 2017-2019). We assessed baseline thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3). Cognitive performance was evaluated every 4 years in each wave using 10-word immediate and late recall, word recognition, semantic (animals category) and phonemic (letter f) verbal fluency, and the trail-making B-version tests. A global composite z-score was derived from these tests. The associations of TSH, FT4, and FT3 levels with cognitive decline over time were evaluated using linear mixed-effect models adjusted for sociodemographic, clinical, and lifestyle variables. Results: In 9 524 participants (mean age 51.2 ± 8.9 years old, 51% women, 52% White), there was no association between baseline TSH, FT4, and FT3 levels and cognitive decline during the follow-up. However, increase in FT4 levels over time was associated with faster memory (β = -0.004, 95% CI = -0.007; -0.001, p = .014), verbal fluency (β = -0.003, 95% CI = -0.007; -0.0005, p = .021), executive function (β = -0.004, 95% CI = -0.011; -0.003, p < .001), and global cognition decline (β = -0.003, 95% CI = -0.006; -0.001, p = .001). Decrease in FT4 levels over time was associated with faster verbal fluency (β = -0.003, 95% CI = -0.007; -0.0004, p = .025) and executive function (β = -0.004, 95% CI = -0.007; -0.0003, p = .031) decline. Conclusions: An increase or decrease in FT4 levels over time was associated with faster cognitive decline in middle-aged and older adults without overt thyroid dysfunction during 8 years of follow-up. (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
Databáze:	MEDLINE
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