Abstract
Dementia, a disabling syndrome of the elderly characterized by the decline in memory and cognition, is increasing in incidence and affects not only the individual but also their family and close ones. Hyperthyroidism can mimic many other diseases and untreated hyperthyroidism can lead to adverse problems of various systems including the heart, bones, muscles, menstrual cycle, and fertility. In this article, we have tried to evaluate the association between hyperthyroidism and dementia, as well as the impact of hyperthyroidism management in the treatment and prevention of dementia. Studies available in the PubMed database have been used, excluding animal studies and including studies of adults above the age of 50. The analysis of studies reveals that thyroid dysfunction can lead to cognitive impairment. It has not been able to prove that hyperthyroidism can lead to an earlier onset of dementia. But subclinical hyperthyroidism, thyroid-stimulating hormone (TSH) levels below the normal range, and high free thyroxine (T4) levels increase the risk of dementia among the elderly. The possible mechanisms involved in this association have also been discussed. Thus, we concluded that it is essential to detect and manage hyperthyroidism at an earlier stage since hyperthyroidism increases the risk of dementia. The possibility of using antithyroid treatment in euthyroid dementia is yet to be studied extensively.
Highlights
BackgroundGraves' disease is the most common cause of hyperthyroidism, followed by toxic nodular goiter
The results showed that lower concentrations of free thyroxine (FT4) are related to fear and fatigue in euthyroid individuals with Alzheimer's disease (AD)
A syndrome of progressive decline in memory, cognition, and behavioral changes, gravely reduces the quality of life in the elderly. Both hypothyroidism and hyperthyroidism have shown to cause severe comorbidities, including cognitive impairment, and we wanted to find out if hyperthyroidism increases the risk of dementia
Summary
Graves' disease is the most common cause of hyperthyroidism, followed by toxic nodular goiter. The effect of normalization of an isolated increase in thyroid stimulating hormone (TSH) on the neuropsychological profile of patients showed that it results in statistically significant improvement of cognitive function -- verbal, visual, and general memory [11]. Euthyroid patients with Alzheimer's disease studied, did not show any significant relation between thyroid hormones and cognition but lower free thyroxine levels were associated with neuropsychiatric symptoms such as fear and fatigue. Disease presentation in the elderly can be highly variable and there have been incidents of treatable and reversible disease conditions being misdiagnosed as dementia Hyperthyroidism is one such condition that presents as dementia and treatment of the thyroid dysfunction in such cases will reverse the cognitive impairment. Appropriate treatment for hyperthyroidism is always essential as it can lead to serious comorbidities
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