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Predictors of thyroid hormone initiation in older adults: results from the cardiovascular health study.

TitlePredictors of thyroid hormone initiation in older adults: results from the cardiovascular health study.
Publication TypeJournal Article
Year of Publication2011
AuthorsSomwaru, LL, Arnold, AM, Cappola, AR
JournalJ Gerontol A Biol Sci Med Sci
Volume66
Issue7
Pagination809-14
Date Published2011 Jul
ISSN1758-535X
KeywordsAged, Aged, 80 and over, Body Mass Index, Cardiovascular Diseases, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Hypothyroidism, Incidence, Male, Prevalence, Prognosis, Retrospective Studies, Risk Factors, Sex Factors, Thyroid Hormones, Thyroxine, Time Factors, United States
Abstract<p><b>BACKGROUND: </b>Despite widespread use, there are no data on initiation of thyroid hormone use in older people. We report the prevalence of thyroid hormone use and predictors of thyroid hormone initiation in a population of older men and women.</p><p><b>METHODS: </b>Thyroid hormone medication data were collected annually from 1989 to 2006 in community-dwelling individuals aged 65 years and older enrolled in the Cardiovascular Health Study (N = 5,888). Associations of age, sex, race, body mass index, education, and coronary heart disease with initiation were evaluated using discrete-time survival analysis.</p><p><b>RESULTS: </b>In 1989-1990, 8.9% (95% confidence interval 8.1%-9.7%) of participants were taking a thyroid hormone preparation, increasing to 20.0% (95% confidence interval 8.2%-21.8%) over 16 years. The average initiation rate was 1% per year. The initiation rate was nonlinear with age, and those aged 85 years and older initiated thyroid hormone more than twice as frequently as those aged 65-69 years (hazard ratio = 2.34; 95% confidence interval 1.43-3.85). White women were more likely to initiate thyroid hormone than any other race and sex group. Higher body mass index was independently associated with higher risk for initiation (p = .002) as was greater education (p = .02) and prevalent coronary heart disease (p = .03).</p><p><b>CONCLUSIONS: </b>Thyroid hormone use is common in older people. The indications and benefits of thyroid hormone use in older individuals with the highest rate of thyroid hormone initiation-the oldest old, overweight and obese individuals, and those with coronary heart disease-should be investigated.</p>
DOI10.1093/gerona/glr063
Alternate JournalJ. Gerontol. A Biol. Sci. Med. Sci.
PubMed ID21628677
PubMed Central IDPMC3143350
Grant ListP30 AG024827 / AG / NIA NIH HHS / United States
N01-HC-80007 / HC / NHLBI NIH HHS / United States
U01 HL-080295 / HL / NHLBI NIH HHS / United States
R01 HL-075366 / HL / NHLBI NIH HHS / United States
P30-AG-024827 / AG / NIA NIH HHS / United States
N01-HC-85086 / HC / NHLBI NIH HHS / United States
N01-HC-35129 / HC / NHLBI NIH HHS / United States
N01 HC-55222 / HC / NHLBI NIH HHS / United States
N01-HC-75150 / HC / NHLBI NIH HHS / United States
N01 HC-15103 / HC / NHLBI NIH HHS / United States
R01 AG032317 / AG / NIA NIH HHS / United States
R01-AG-023629 / AG / NIA NIH HHS / United States
N01-HC-45133 / HC / NHLBI NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States
R01-AG-015928 / AG / NIA NIH HHS / United States
R01-AG032317 / AG / NIA NIH HHS / United States
R01-AG-020098 / AG / NIA NIH HHS / United States
R01-AG-027058 / AG / NIA NIH HHS / United States