Subclinical Thyroid Dysfunction and Depressive Symptoms among Elderly: A Prospective Cohort Study

Manuel R Blum; Liselotte W Wijsman; Vanessa S Virgini; Douglas C Bauer; Wendy P J den Elzen; J Wouter Jukema; Brendan M Buckley; Anton J M de Craen; Patricia M Kearney; David J Stott; Jacobjin Gussekloo; Rudi G J Westendorp; Simon P Mooijaart; Nicolas Rodondi

doi:10.1159/000437387

Subclinical Thyroid Dysfunction and Depressive Symptoms among Elderly: A Prospective Cohort Study

Manuel R Blum, Liselotte W Wijsman, Vanessa S Virgini, Douglas C Bauer, Wendy P J den Elzen, J Wouter Jukema, Brendan M Buckley, Anton J M de Craen, Patricia M Kearney, David J Stott, Jacobjin Gussekloo, Rudi G J Westendorp, Simon P Mooijaart, Nicolas Rodondi

33 Citations (Scopus)

Abstract

Background: Subclinical hypothyroidism has been associated with depressive symptoms in cross-sectional studies, but prospective data and data on subclinical hyperthyroidism are scarce. Methods: In the Leiden substudy of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), thyroid-stimulating hormone and free T₄ levels were measured at baseline and repeated after 6 months in adults aged 70-82 years with preexisting cardiovascular disease or known cardiovascular risk factors to define persistent thyroid functional status. Main outcome measures were depressive symptoms, assessed with the Geriatric Depression Scale 15 (GDS-15) at baseline and after 3 years. All analyses were adjusted for age, gender and education. Results: In 606 participants (41% women; mean age 75 years) without antidepressant medication, GDS-15 scores at baseline did not differ for participants with subclinical hypothyroidism (n = 47; GDS-15 score 1.75, 95% CI 1.29-2.20, p = 0.53) or subclinical hyperthyroidism (n = 13; GDS-15 score 1.64, 95% CI 0.78-2.51, p = 0.96) compared to euthyroid participants (n = 546; mean GDS-15 score 1.60, 95% CI 1.46-1.73). After 3 years, compared to the euthyroid participants, changes in GDS-15 scores did not differ for participants with subclinical hypothyroidism (ΔGDS-15 score -0.03, 95% CI-0.50 to 0.44, p = 0.83), while subclinical hyperthyroidism was associated with an increase in GDS scores (ΔGDS-15 score 1.13, 95% CI 0.32-1.93, p = 0.04). All results were similar for persistent subclinical thyroid dysfunction. Conclusions: In this largest prospective study on the association of persistent subclinical thyroid dysfunction and depression, subclinical hypothyroidism was not associated with increased depressive symptoms among older adults at high cardiovascular risk. Persistent subclinical hyperthyroidism might be associated with increased depressive symptoms, which requires confirmation in a larger prospective study.

Original language	English
Journal	Neuroendocrinology
Volume	103
Issue number	3-4
Pages (from-to)	291-299
Number of pages	9
ISSN	0028-3835
DOIs	https://doi.org/10.1159/000437387
Publication status	Published - 1 May 2016

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10.1159/000437387

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Blum, M. R., Wijsman, L. W., Virgini, V. S., Bauer, D. C., den Elzen, W. P. J., Jukema, J. W., Buckley, B. M., de Craen, A. J. M., Kearney, P. M., Stott, D. J., Gussekloo, J., Westendorp, R. G. J., Mooijaart, S. P., & Rodondi, N. (2016). Subclinical Thyroid Dysfunction and Depressive Symptoms among Elderly: A Prospective Cohort Study. Neuroendocrinology, 103(3-4), 291-299. https://doi.org/10.1159/000437387

Blum, MR, Wijsman, LW, Virgini, VS, Bauer, DC, den Elzen, WPJ, Jukema, JW, Buckley, BM, de Craen, AJM, Kearney, PM, Stott, DJ, Gussekloo, J, Westendorp, RGJ, Mooijaart, SP & Rodondi, N 2016, 'Subclinical Thyroid Dysfunction and Depressive Symptoms among Elderly: A Prospective Cohort Study', Neuroendocrinology, vol. 103, no. 3-4, pp. 291-299. https://doi.org/10.1159/000437387

@article{cc03eef77aa3459b89707c84c6ebb092,

title = "Subclinical Thyroid Dysfunction and Depressive Symptoms among Elderly: A Prospective Cohort Study",

abstract = "Background: Subclinical hypothyroidism has been associated with depressive symptoms in cross-sectional studies, but prospective data and data on subclinical hyperthyroidism are scarce. Methods: In the Leiden substudy of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), thyroid-stimulating hormone and free T4 levels were measured at baseline and repeated after 6 months in adults aged 70-82 years with preexisting cardiovascular disease or known cardiovascular risk factors to define persistent thyroid functional status. Main outcome measures were depressive symptoms, assessed with the Geriatric Depression Scale 15 (GDS-15) at baseline and after 3 years. All analyses were adjusted for age, gender and education. Results: In 606 participants (41% women; mean age 75 years) without antidepressant medication, GDS-15 scores at baseline did not differ for participants with subclinical hypothyroidism (n = 47; GDS-15 score 1.75, 95% CI 1.29-2.20, p = 0.53) or subclinical hyperthyroidism (n = 13; GDS-15 score 1.64, 95% CI 0.78-2.51, p = 0.96) compared to euthyroid participants (n = 546; mean GDS-15 score 1.60, 95% CI 1.46-1.73). After 3 years, compared to the euthyroid participants, changes in GDS-15 scores did not differ for participants with subclinical hypothyroidism (ΔGDS-15 score -0.03, 95% CI-0.50 to 0.44, p = 0.83), while subclinical hyperthyroidism was associated with an increase in GDS scores (ΔGDS-15 score 1.13, 95% CI 0.32-1.93, p = 0.04). All results were similar for persistent subclinical thyroid dysfunction. Conclusions: In this largest prospective study on the association of persistent subclinical thyroid dysfunction and depression, subclinical hypothyroidism was not associated with increased depressive symptoms among older adults at high cardiovascular risk. Persistent subclinical hyperthyroidism might be associated with increased depressive symptoms, which requires confirmation in a larger prospective study.",

author = "Blum, {Manuel R} and Wijsman, {Liselotte W} and Virgini, {Vanessa S} and Bauer, {Douglas C} and {den Elzen}, {Wendy P J} and Jukema, {J Wouter} and Buckley, {Brendan M} and {de Craen}, {Anton J M} and Kearney, {Patricia M} and Stott, {David J} and Jacobjin Gussekloo and Westendorp, {Rudi G J} and Mooijaart, {Simon P} and Nicolas Rodondi",

year = "2016",

month = may,

day = "1",

doi = "10.1159/000437387",

language = "English",

volume = "103",

pages = "291--299",

journal = "Neuroendocrinology",

issn = "0028-3835",

publisher = "S Karger AG",

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TY - JOUR

T1 - Subclinical Thyroid Dysfunction and Depressive Symptoms among Elderly

T2 - A Prospective Cohort Study

AU - Blum, Manuel R

AU - Wijsman, Liselotte W

AU - Virgini, Vanessa S

AU - Bauer, Douglas C

AU - den Elzen, Wendy P J

AU - Jukema, J Wouter

AU - Buckley, Brendan M

AU - de Craen, Anton J M

AU - Kearney, Patricia M

AU - Stott, David J

AU - Gussekloo, Jacobjin

AU - Westendorp, Rudi G J

AU - Mooijaart, Simon P

AU - Rodondi, Nicolas

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Background: Subclinical hypothyroidism has been associated with depressive symptoms in cross-sectional studies, but prospective data and data on subclinical hyperthyroidism are scarce. Methods: In the Leiden substudy of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), thyroid-stimulating hormone and free T4 levels were measured at baseline and repeated after 6 months in adults aged 70-82 years with preexisting cardiovascular disease or known cardiovascular risk factors to define persistent thyroid functional status. Main outcome measures were depressive symptoms, assessed with the Geriatric Depression Scale 15 (GDS-15) at baseline and after 3 years. All analyses were adjusted for age, gender and education. Results: In 606 participants (41% women; mean age 75 years) without antidepressant medication, GDS-15 scores at baseline did not differ for participants with subclinical hypothyroidism (n = 47; GDS-15 score 1.75, 95% CI 1.29-2.20, p = 0.53) or subclinical hyperthyroidism (n = 13; GDS-15 score 1.64, 95% CI 0.78-2.51, p = 0.96) compared to euthyroid participants (n = 546; mean GDS-15 score 1.60, 95% CI 1.46-1.73). After 3 years, compared to the euthyroid participants, changes in GDS-15 scores did not differ for participants with subclinical hypothyroidism (ΔGDS-15 score -0.03, 95% CI-0.50 to 0.44, p = 0.83), while subclinical hyperthyroidism was associated with an increase in GDS scores (ΔGDS-15 score 1.13, 95% CI 0.32-1.93, p = 0.04). All results were similar for persistent subclinical thyroid dysfunction. Conclusions: In this largest prospective study on the association of persistent subclinical thyroid dysfunction and depression, subclinical hypothyroidism was not associated with increased depressive symptoms among older adults at high cardiovascular risk. Persistent subclinical hyperthyroidism might be associated with increased depressive symptoms, which requires confirmation in a larger prospective study.

AB - Background: Subclinical hypothyroidism has been associated with depressive symptoms in cross-sectional studies, but prospective data and data on subclinical hyperthyroidism are scarce. Methods: In the Leiden substudy of the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER), thyroid-stimulating hormone and free T4 levels were measured at baseline and repeated after 6 months in adults aged 70-82 years with preexisting cardiovascular disease or known cardiovascular risk factors to define persistent thyroid functional status. Main outcome measures were depressive symptoms, assessed with the Geriatric Depression Scale 15 (GDS-15) at baseline and after 3 years. All analyses were adjusted for age, gender and education. Results: In 606 participants (41% women; mean age 75 years) without antidepressant medication, GDS-15 scores at baseline did not differ for participants with subclinical hypothyroidism (n = 47; GDS-15 score 1.75, 95% CI 1.29-2.20, p = 0.53) or subclinical hyperthyroidism (n = 13; GDS-15 score 1.64, 95% CI 0.78-2.51, p = 0.96) compared to euthyroid participants (n = 546; mean GDS-15 score 1.60, 95% CI 1.46-1.73). After 3 years, compared to the euthyroid participants, changes in GDS-15 scores did not differ for participants with subclinical hypothyroidism (ΔGDS-15 score -0.03, 95% CI-0.50 to 0.44, p = 0.83), while subclinical hyperthyroidism was associated with an increase in GDS scores (ΔGDS-15 score 1.13, 95% CI 0.32-1.93, p = 0.04). All results were similar for persistent subclinical thyroid dysfunction. Conclusions: In this largest prospective study on the association of persistent subclinical thyroid dysfunction and depression, subclinical hypothyroidism was not associated with increased depressive symptoms among older adults at high cardiovascular risk. Persistent subclinical hyperthyroidism might be associated with increased depressive symptoms, which requires confirmation in a larger prospective study.

U2 - 10.1159/000437387

DO - 10.1159/000437387

M3 - Journal article

C2 - 26202797

SN - 0028-3835

VL - 103

SP - 291

EP - 299

JO - Neuroendocrinology

JF - Neuroendocrinology

IS - 3-4

ER -

Subclinical Thyroid Dysfunction and Depressive Symptoms among Elderly: A Prospective Cohort Study

Abstract

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