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Association of Thyroid Dysfunction With Cognitive Function: An Individual Participant Data Analysis

dc.rights.licenseopenen_US
dc.contributor.authorVAN VLIET, Nicolien A.
dc.contributor.authorVAN HEEMST, Diana
dc.contributor.authorALMEIDA, Osvaldo P.
dc.contributor.authorASVOLD, Bjorn O.
dc.contributor.authorAUBERT, Carole E.
dc.contributor.authorBAE, Jong Bin
dc.contributor.authorBARNES, Linda E.
dc.contributor.authorBAUER, Douglas C.
dc.contributor.authorBLAUW, Gerard J.
dc.contributor.authorBRAYNE, Carol
dc.contributor.authorCAPPOLA, Anne R.
dc.contributor.authorCERESINI, Graziano
dc.contributor.authorCOMIJS, Hannie C.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorDARTIGUES, Jean-Francois
dc.contributor.authorDEGRYSE, Jean-Marie
dc.contributor.authorDULLAART, Robin P. F.
dc.contributor.authorVAN EERSEL, Marlise E. A.
dc.contributor.authorDEN ELZEN, Wendy P. J.
dc.contributor.authorFERRUCCI, Luigi
dc.contributor.authorFINK, Howard A.
dc.contributor.authorFLICKER, Leon
dc.contributor.authorGRABE, Hans J.
dc.contributor.authorHAN, Ji Won
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorHELMER, Catherine
dc.contributor.authorHUISMAN, Martijn
dc.contributor.authorIKRAM, M. Arfan
dc.contributor.authorIMAIZUMI, Misa
dc.contributor.authorDE JONGH, Renate T.
dc.contributor.authorJUKEMA, J. Wouter
dc.contributor.authorKIM, Ki Woong
dc.contributor.authorKULLER, Lewis H.
dc.contributor.authorLOPEZ, Oscar L.
dc.contributor.authorMOOIJAART, Simon P.
dc.contributor.authorMOON, Jae Hoon
dc.contributor.authorMOUTZOURI, Elisavet
dc.contributor.authorNAUCK, Matthias
dc.contributor.authorPARLE, Jim
dc.contributor.authorPEETERS, Robin P.
dc.contributor.authorSAMUELS, Mary H.
dc.contributor.authorSCHMIDT, Carsten O.
dc.contributor.authorSCHMINKE, Ulf
dc.contributor.authorSLAGBOOM, P. Eline
dc.contributor.authorSTORDAL, Eystein
dc.contributor.authorVAES, Bert
dc.contributor.authorVOLZKE, Henry
dc.contributor.authorWESTENDORP, Rudi G. J.
dc.contributor.authorYAMADA, Michiko
dc.contributor.authorYEAP, Bu B.
dc.contributor.authorRODONDI, Nicolas
dc.contributor.authorGUSSEKLOO, Jacobijn
dc.contributor.authorTROMPET, Stella
dc.contributor.authorTHYROID STUDIES, Collaboration
dc.date.accessioned2021-11-08T14:24:54Z
dc.date.available2021-11-08T14:24:54Z
dc.date.issued2021-09-07
dc.identifier.issn2168-6114 (Electronic) 2168-6106 (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/123780
dc.description.abstractEnImportance: In clinical guidelines, overt and subclinical thyroid dysfunction are mentioned as causal and treatable factors for cognitive decline. However, the scientific literature on these associations shows inconsistent findings. Objective: To assess cross-sectional and longitudinal associations of baseline thyroid dysfunction with cognitive function and dementia. Design, Setting, and Participants: This multicohort individual participant data analysis assessed 114267 person-years (median, 1.7-11.3 years) of follow-up for cognitive function and 525222 person-years (median, 3.8-15.3 years) for dementia between 1989 and 2017. Analyses on cognitive function included 21 cohorts comprising 38144 participants. Analyses on dementia included eight cohorts with a total of 2033 cases with dementia and 44573 controls. Data analysis was performed from December 2016 to January 2021. Exposures: Thyroid function was classified as overt hyperthyroidism, subclinical hyperthyroidism, euthyroidism, subclinical hypothyroidism, and overt hypothyroidism based on uniform thyrotropin cutoff values and study-specific free thyroxine values. Main Outcomes and Measures: The primary outcome was global cognitive function, mostly measured using the Mini-Mental State Examination. Executive function, memory, and dementia were secondary outcomes. Analyses were first performed at study level using multivariable linear regression and multivariable Cox regression, respectively. The studies were combined with restricted maximum likelihood meta-analysis. To overcome the use of different scales, results were transformed to standardized mean differences. For incident dementia, hazard ratios were calculated. Results: Among 74565 total participants, 66567 (89.3%) participants had normal thyroid function, 577 (0.8%) had overt hyperthyroidism, 2557 (3.4%) had subclinical hyperthyroidism, 4167 (5.6%) had subclinical hypothyroidism, and 697 (0.9%) had overt hypothyroidism. The study-specific median age at baseline varied from 57 to 93 years; 42847 (57.5%) participants were women. Thyroid dysfunction was not associated with global cognitive function; the largest differences were observed between overt hypothyroidism and euthyroidism-cross-sectionally (-0.06 standardized mean difference in score; 95% CI, -0.20 to 0.08; P = .40) and longitudinally (0.11 standardized mean difference higher decline per year; 95% CI, -0.01 to 0.23; P = .09). No consistent associations were observed between thyroid dysfunction and executive function, memory, or risk of dementia. Conclusions and Relevance: In this individual participant data analysis of more than 74000 adults, subclinical hypothyroidism and hyperthyroidism were not associated with cognitive function, cognitive decline, or incident dementia. No rigorous conclusions can be drawn regarding the role of overt thyroid dysfunction in risk of dementia. These findings do not support the practice of screening for subclinical thyroid dysfunction in the context of cognitive decline in older adults as recommended in current guidelines.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.title.enAssociation of Thyroid Dysfunction With Cognitive Function: An Individual Participant Data Analysis
dc.typeArticle de revueen_US
dc.identifier.doi10.1001/jamainternmed.2021.5078en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed34491268en_US
bordeaux.journalJAMA Internal Medicineen_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamSEPIAen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03419544
hal.version1
hal.date.transferred2021-11-08T14:25:04Z
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=JAMA%20Internal%20Medicine&rft.date=2021-09-07&rft.eissn=2168-6114%20(Electronic)%202168-6106%20(Linking)&rft.issn=2168-6114%20(Electronic)%202168-6106%20(Linking)&rft.au=VAN%20VLIET,%20Nicolien%20A.&VAN%20HEEMST,%20Diana&ALMEIDA,%20Osvaldo%20P.&ASVOLD,%20Bjorn%20O.&AUBERT,%20Carole%20E.&rft.genre=article


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