title: Is thyroid status associated with cognitive impairment in elderly patients in China?
abstract: BACKGROUND
  The relationship between alterations in thyroid function and cognitive deficits has been investigated in several previous studies. Hypo-or hyperthyroidism and, to a lesser extent, subclinical thyroid dysfunction can negatively affect cognitive performance. However, limited data are available on the potential association of thyroid function with mild cognitive impairment (MCI) and Alzheimer's disease (AD) in the elderly Chinese population.
  
  
  METHODS
  In the present study focusing on a population of elderly Chinese individuals ≥ 50 years of age, 77 cognitively normal controls, 64 patients with MCI, and 154 patients diagnosed with AD underwent assessment of thyroid status using thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) levels as variables. Cognitive function was evaluated with the aid of comprehensive neuropsychological tests, such as the Mini-Mental State Examination (MMSE) and Memory and Executive Screening (MES).
  
  
  RESULTS
  Overall, 88.1 % of the subjects displayed normal thyroid function, 4.7 % were diagnosed with clinical hypothyroidism, 3.1 % with subclinical hypothyroidism, and 4.1 % with subclinical hyperthyroidism. After adjusting for covariates (age, sex, education years and body mass index), no association was evident between mild cognitive impairment or AD and thyroid dysfunction. However, lower serum TSH was correlated with risk of AD (odds ratio [OR]: 2.78, 95 % confidence interval [95% CI]: 1.11-6.99).
  
  
  CONCLUSIONS
  Neither hypothyroidism nor subclinical hyperthyroidism was associated with AD and MCI in this population-based elderly Chinese cohort. Our findings need to be confirmed in a longitudinal study.
authors.affiliation: Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China. huyaodolphin@sina.cn.
authors.forename: Yao
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
authors.forename: Zhi-cheng
authors.initials: ZC
authors.lastname: Wang
authors.affiliation: Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
authors.forename: Qi-hao
authors.initials: QH
authors.lastname: Guo
authors.affiliation: Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Cheng
authors.affiliation: Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
authors.forename: Yan-wen
authors.initials: YW
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000544:Alzheimer Disease / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006304:Health Status; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D007037:Hypothyroidism / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000502:physiology*