title: Subclinical Thyroid Dysfunction and Depressive Symptoms among the Elderly: A Prospective Cohort Study.
abstract: Subclinical hypothyroidism has been associated with depressive symptoms in cross-sectional studies, but prospective data and data on subclinical hyperthyroidism are scarce.
  
  
  
  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.
  
  
  
  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 (x0394;GDS-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 (x0394;GDS-15 score 1.13, 95% CI 0.32-1.93, p = 0.04). All results were similar for persistent subclinical thyroid dysfunction.
  
  
  
  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.
authors.affiliation: Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
authors.forename: Manuel R
authors.initials: MR
authors.lastname: Blum
authors.forename: Liselotte W
authors.initials: LW
authors.lastname: Wijsman
authors.forename: Vanessa S
authors.initials: VS
authors.lastname: Virgini
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.forename: Wendy P J
authors.initials: WP
authors.lastname: den Elzen
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: Brendan M
authors.initials: BM
authors.lastname: Buckley
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Kearney
authors.forename: David J
authors.initials: DJ
authors.lastname: Stott
authors.forename: Jacobjin
authors.initials: J
authors.lastname: Gussekloo
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
authors.forename: Simon P
authors.initials: SP
authors.lastname: Mooijaart
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D013959:Thyroid Diseases / Q000453:epidemiology*; D013960:Thyroid Function Tests; D013963:Thyroid Hormones / Q000378:metabolism; D013972:Thyrotropin / Q000378:metabolism
chemical_list: D013963:Thyroid Hormones; D013972:Thyrotropin