title: Thyroid-Stimulating Hormone and Mild Cognitive Impairment: Results of the Heinz Nixdorf Recall Study.
abstract: BACKGROUND
  Although some studies reported on the association of serum thyroid-stimulating hormone (TSH) concentration and cognition, only one population-based study investigated the association of TSH concentration and mild cognitive impairment (MCI).
  
  
  OBJECTIVE
  To investigate the gender-specific association of low- and high-normal TSH concentrations with MCI in euthyroid participants.
  
  
  METHODS
  Analysis sample 1 included 2,563 euthyroid participants (aged 50-80 years) from the second examination of the population-based Heinz Nixdorf Recall study. Gender-specific TSH quintiles (Q1 low, Q2-Q4 middle, Q5 high TSH concentration) were determined and group comparisons of age- and education-adjusted mean scores were performed for all cognitive subtests. Analysis sample 2 included 378 participants with MCI and 931 cognitively normal participants. MCI was diagnosed according to previously published MCI criteria. Multivariate logistic regression models were performed using TSH quintiles (Q2-Q4 as reference) to assess the association of low- and high-normal TSH concentration with MCI. Models were performed unadjusted and adjusted for sociodemographic and cardiovascular risk factors.
  
  
  RESULTS
  Group comparisons showed significant differences only in the immediate recall of the verbal memory task in women. Only women showed a strong association of high-normal TSH concentration with MCI (unadjusted: odds ratio 2.09, 95% confidence interval 1.29-3.37, full adjusted: 1.86, 1.06-3.27). There was no association with low-normal TSH concentration in women and no association of either low- or high-normal TSH concentration with MCI in men.
  
  
  CONCLUSIONS
  These results suggest that women with high-normal TSH concentration might be at higher risk of cognitive decline. This needs to be confirmed in the longitudinal analysis.
authors.affiliation: Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany.
authors.forename: Angela
authors.initials: A
authors.lastname: Winkler
authors.affiliation: Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Weimar
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.affiliation: Clinic of Cardiology, West German Heart Centre, University Hospital of Essen, University Duisburg-Essen, Germany.
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.affiliation: Institute for Medical Sociology, Centre for Healthy and Society, University of Düsseldorf, Germany.
authors.forename: Nico
authors.initials: N
authors.lastname: Dragano
authors.affiliation: Department of Endocrinology and Metabolism, and Division of Laboratory Research, University Duisburg-Essen, Essen, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Broecker-Preuss
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
authors.affiliation: Department of Endocrinology, University Hospital of Essen, University of Duisburg-Essen, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Führer-Sakel
authors.affiliation: Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany.
authors.forename: Martha
authors.initials: M
authors.lastname: Dlugaj
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000503:physiopathology; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D012727:Sex Characteristics; D018709:Statistics, Nonparametric; D013972:Thyrotropin / Q000097:blood*
chemical_list: D013972:Thyrotropin
keywords: Aging; gender; mild cognitive impairment; population-based studies; thyroid function; thyroid-stimulating hormone