甲状腺功能与认知能力衰退：叙述性综述。

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2024-11-01 DOI:10.1016/j.eprac.2024.07.013

Sophia Hemmrich Sinha MD , Kahli Zietlow MD , Maria Papaleontiou MD

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引用次数: 0

摘要

目的：随着美国老年人口的不断增加，了解导致认知能力下降和痴呆症的可改变风险因素变得越来越重要。本综述总结了有关甲状腺功能在甲状腺功能正常范围内、甲状腺功能减退症和甲状腺功能亢进症与老年人认知结果之间关系的现有文献：对 PubMed 和 Ovid/Medline 数据库进行了全面的文献检索。方法：对 PubMed 和 Ovid/Medline 数据库进行了全面的文献检索，纳入了 2000 年 1 月至 2023 年 12 月间用英语发表的随机对照试验、系统综述、荟萃分析和观察性研究：总体而言，现有研究得出的结果相互矛盾，未能确定甲状腺功能与老年人认知结果和/或痴呆症之间的具体关系。在参考范围内较高的促甲状腺激素与较低的痴呆症发病风险之间可能存在关联，这种关联在女性中可能更为明显。大多数研究阐明了低促甲状腺激素与痴呆症之间可能存在的联系，并认为甲状腺功能亢进症的持续时间可能会增加痴呆症的风险。尽管有关甲状腺功能减退症与认知能力下降之间关系的证据并不一致，但目前的数据并不支持通过治疗亚临床甲状腺功能减退症来改善老年人的认知能力：结论：尽管研究众多，但没有确凿证据支持甲状腺功能亢进或甲减与认知能力下降之间存在直接关系。研究的局限性包括研究设计、测量方法和认知评估工具的异质性。未来的研究需要更好地界定两者之间是否存在关联，以及治疗甲状腺功能障碍是否能改善认知障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Thyroid Function and Cognitive Decline: A Narrative Review

Objective

As the population of older adults in the United States continues to rise, understanding modifiable risk factors that contribute to cognitive decline and dementia becomes increasingly important. This narrative review summarizes existing literature on the association between thyroid function in the euthyroid range, hypothyroidism and hyperthyroidism, and cognitive outcomes in older adults.

Methods

A comprehensive literature search of the PubMed and Ovid/Medline databases was conducted. Randomized controlled trials, systematic reviews, meta-analyses, and observational studies published in English between January 2000 and December 2023 were included.

Results

Overall, existing studies yielded conflicting results, failing to delineate a concrete relationship between thyroid function and cognitive outcomes and/or dementia in older adults. There may be a possible association between higher thyroid stimulating hormone in the reference range and lower risk of incident dementia, which may be more pronounced in women. Majority of studies elucidated a possible association between low thyroid stimulating hormone and incident dementia, with suggestion that duration of hyperthyroidism may contribute to increasing dementia risk. Even though evidence on the association of hypothyroidism and cognitive decline are disparate, current data do not support treatment of subclinical hypothyroidism to improve cognitive outcomes in older adults.

Conclusion

Despite numerous studies, there is no conclusive evidence that supports a direct relationship between hyperthyroidism or hypothyroidism and cognitive decline. Study limitations include heterogeneity in study designs, measurement methodologies, and cognitive assessment tools. Future research is needed to better delineate whether an association exists and whether treatment of thyroid dysfunction ameliorates cognitive impairment.

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.