Is Hypothyroidism Tied to Mortality in Elderly?

Hypothyroidism may be associated with significant all-cause mortality in elderly patients, according to findings from a new systematic review and meta-analysis. However, the authors of the study noted, further research is warranted due to heterogeneity between studies.

The researchers arrived at their conclusion after examining data from 27 cohort studies (N = 1,114,638) that had assessed the association between hypothyroidism and all-cause and/or cardiovascular mortality among patients aged 60 years or older. Data from inception until May 10, 2019, were obtained from PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases.

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Results indicated that, overall, the risk of all-cause mortality was higher in patients with hypothyroidism compared with those with euthyroidism (pooled risk ratio [RR] 1.26). However, no significant difference in cardiovascular mortality was observed between patients with hypothyroidism and patients with euthyroidism (pooled RR 1.10).

In subgroup analyses, overt hypothyroidism (pooled RR 1.10) was found to be associated with increased all-cause mortality, but subclinical hypothyroidism was not (pooled RR 1.14). The researchers noted that heterogeneity between studies was largely due to different study designs (prospective and retrospective) and geographic locations where studies were performed (Europe, North America, Asia, and Oceania).

“Based on the current evidence, hypothyroidism is significantly associated with increased all-cause mortality instead of cardiovascular mortality among the elderly,” the researchers concluded. “We observed considerable heterogeneity, so caution is needed when interpreting the results. Further prospective large-scale high-quality studies are warranted to confirm these findings.”

—Christina Vogt

Reference:

Tsai TY, Tu YK, Munir KM, et al. Association of hypothyroidism and mortality in the elderly population: A systematic review and meta-analysis [Published online December 12, 2019]. J Clin Endocrinol Metab. https://doi.org/10.1210/clinem/dgz186.