title: Serum Thyroid Function, Mortality and Disability in Advanced Old Age: The Newcastle 85+ Study.
abstract: Perturbations in thyroid function are common in older individuals but their significance in the very old is not fully understood.
  
  
  
  This study sought to determine whether thyroid hormone status and variation of thyroid hormones within the reference range correlated with mortality and disability in a cohort of 85-year-olds.
  
  
  
  A cohort of 85-year-old individuals were assessed in their own homes (community or institutional care) for health status and thyroid function, and followed for mortality and disability for up to 9 years.
  
  
  
  Six hundred and forty-three 85-year-olds registered with participating general practices in Newcastle and North Tyneside, United Kingdom.
  
  
  
  All-cause mortality, cardiovascular mortality, and disability according to thyroid disease status and baseline thyroid hormone parameters (serum TSH, FT4, FT3, and rT3). Models were adjusted for age, sex, education, body mass index, smoking, and disease count.
  
  
  
  After adjustment for age and sex, all-cause mortality was associated with baseline serum rT3and FT3(both P < .001), but not FT4or TSH. After additional adjustment for potential confounders, only rT3remained significantly associated with mortality (P = .001). Baseline serum TSH and rT3predicted future disability trajectories in men and women, respectively.
  
  
  
  Our study is reassuring that individuals age 85 y with both subclinical hypothyroidism and subclinical hyperthyroidism do not have a significantly worse survival over 9 years than their euthyroid peers. However, thyroid function tests did predict disability, with higher serum TSH levels predicting better outcomes. These data strengthen the argument for routine use of age-specific thyroid function reference ranges.
authors.affiliation: Institute of Genetic Medicine (S.H.S.P., S.R.), Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom; Institute of Health and Society (M.E.Y., C.M.-R., A.K., J.C., T.B.K., C.J.), Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom; and Department of Internal Medicine (T.J.V.), Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Simon H S
authors.initials: SH
authors.lastname: Pearce
authors.affiliation: Institute of Genetic Medicine (S.H.S.P., S.R.), Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom; Institute of Health and Society (M.E.Y., C.M.-R., A.K., J.C., T.B.K., C.J.), Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom; and Department of Internal Medicine (T.J.V.), Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Salman
authors.initials: S
authors.lastname: Razvi
authors.affiliation: Institute of Genetic Medicine (S.H.S.P., S.R.), Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom; Institute of Health and Society (M.E.Y., C.M.-R., A.K., J.C., T.B.K., C.J.), Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom; and Department of Internal Medicine (T.J.V.), Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Mohammad E
authors.initials: ME
authors.lastname: Yadegarfar
authors.affiliation: Institute of Genetic Medicine (S.H.S.P., S.R.), Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom; Institute of Health and Society (M.E.Y., C.M.-R., A.K., J.C., T.B.K., C.J.), Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom; and Department of Internal Medicine (T.J.V.), Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Carmen
authors.initials: C
authors.lastname: Martin-Ruiz
authors.affiliation: Institute of Genetic Medicine (S.H.S.P., S.R.), Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom; Institute of Health and Society (M.E.Y., C.M.-R., A.K., J.C., T.B.K., C.J.), Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom; and Department of Internal Medicine (T.J.V.), Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Andrew
authors.initials: A
authors.lastname: Kingston
authors.affiliation: Institute of Genetic Medicine (S.H.S.P., S.R.), Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom; Institute of Health and Society (M.E.Y., C.M.-R., A.K., J.C., T.B.K., C.J.), Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom; and Department of Internal Medicine (T.J.V.), Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Joanna
authors.initials: J
authors.lastname: Collerton
authors.affiliation: Institute of Genetic Medicine (S.H.S.P., S.R.), Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom; Institute of Health and Society (M.E.Y., C.M.-R., A.K., J.C., T.B.K., C.J.), Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom; and Department of Internal Medicine (T.J.V.), Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Theo J
authors.initials: TJ
authors.lastname: Visser
authors.affiliation: Institute of Genetic Medicine (S.H.S.P., S.R.), Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom; Institute of Health and Society (M.E.Y., C.M.-R., A.K., J.C., T.B.K., C.J.), Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom; and Department of Internal Medicine (T.J.V.), Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Tom B
authors.initials: TB
authors.lastname: Kirkwood
authors.affiliation: Institute of Genetic Medicine (S.H.S.P., S.R.), Newcastle University, Newcastle upon Tyne NE1 3BZ, United Kingdom; Institute of Health and Society (M.E.Y., C.M.-R., A.K., J.C., T.B.K., C.J.), Newcastle University, Newcastle upon Tyne NE2 4AX, United Kingdom; and Department of Internal Medicine (T.J.V.), Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
mesh_terms: D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality*; D003918:Dextrothyroxine / Q000097:blood; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D012016:Reference Values; D013959:Thyroid Diseases / Q000097:blood* / Q000453:epidemiology*; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood; D014285:Triiodothyronine, Reverse / Q000097:blood*
chemical_list: D014284:Triiodothyronine; D003918:Dextrothyroxine; D014285:Triiodothyronine, Reverse; D013972:Thyrotropin