Thyroid dysfunction in the elderly

Abstract

This study was performed to demonstrate that screening can detect unsuspected thyroid disease and that some patients may in fact benefit. The objectives of the project were to examine the prevalence of recognized and unrecognized cases of thyroid disease in the elderly in Malta, to determine whether accepted clinical signs and symptoms of thyroid dysfunction correlated with laboratory findings, to investigate the influence of drug therapy on thyroid function and to investigate the possible association between diabetes (and possibly other autoimmune diseases) and thyroid dysfunction. A total of 873 geriatric unselected consecutive admissions to Zammit Clapp hospital, an acute care geriatric hospital and the admission at The Saint Vincent de Paule Residence for the elderly, were specifically assessed for symptoms and signs of thyroid dysfunction. The study encompassed community-dwelling elderly patients who were referred by their general practitioner to the above mentioned clinics. The patient population ranged in age from 41 to 103 years, with a mean age of 78.626 years. 99.427% of the patients were over 60 years of age ; the few remaining patients (0.573%) under 60 years of age were physically and / or mentally disabled. The male : female ratio was 1 : 1.9724. A total of 104 variables for all the patients admitted were finally analysed using the British Medical Data Package (BMDP) method of statistical analysis ; the above variables encompassed any present or past medical condition and nay drug therapy (amounting to a total of 295 different drugs which were later subdivided into their respective classes).