ABSTRACT
OBJECTIVE: To investigate the association between thyroid-stimulating hormone (TSH) and clinically relevant depression (CRD) in a population-based study. PATIENTS AND METHODS: Adult patients (≥18 years of age) who received care at Mayo Clinic in Rochester, Minnesota, and completed a TSH and Patient Health Questionnaire - 9 (PHQ-9) within 6 months of each other, between July 8, 2017, and August 31, 2021, were included. Demographics, medical comorbidities, thyroid function laboratory data, psychotropic medications, presence of primary thyroid disorder, thyroid hormone replacement (T4 and/or T3), and mood disorder diagnoses (using International Classification of Diseases, 10th version, Clinical Modifications codes) were extracted electronically. The primary outcome, CRD, was defined as a PHQ-9 score greater than or equal to 10. Logistic regression analysis was conducted to assess the association between TSH categories (low ≤0.3 mIU/L; normal >0.3-4.2 mIU/L; high >4.2 mIU/L) and CRD. RESULTS: The cohort included 29,034 patients, mean age 51.4 years, 65% females, 89.9% White, and a mean body mass index of 29.9 kg/m2. The mean ± standard deviation for TSH was 3.0±8.5 mIU/L, and the mean PHQ-9 score was 6.3±6.2. After adjustment, the odds of CRD were significantly higher among the low TSH category (odds ratio, 1.37; 95% CI, 1.18-1.57; P<.001) compared with the normal TSH category, especially in people 70 years of age or younger compared with people older than 70 years of age. Subgroup analysis did not show an increase in odds of CRD among patients with subclinical/overt hypothyroidism/hyperthyroidism (after adjustment). CONCLUSION: In this large population-based cross-sectional study, we report that low TSH was associated with higher odds of depression. Future longitudinal cohort studies are needed to investigate the relationship between thyroid dysfunction and depression as well as sex differences.
Subject(s)
Hyperthyroidism , Hypothyroidism , Thyroid Diseases , Adult , Humans , Female , Male , Middle Aged , Infant , Aged , Thyrotropin , Cohort Studies , Depression/epidemiology , Cross-Sectional Studies , Hypothyroidism/complications , Hypothyroidism/epidemiology , Thyroid Diseases/complications , Hyperthyroidism/complications , ThyroxineABSTRACT
Objective. This study examines the extent to which optimism, control beliefs and motivation, and downward social comparison contribute independently to the maintenance of older adults positive self-evaluations in a functional domain. Method. Adaptive resources/strategies and life satisfaction were measured in personal interviews with 164 community-dwelling older adults. Participants judged their physical activity compared with the average person of their age and wore an accelerometer for 24 hours. Commonality analysis was used to estimate unique versus shared effects of the resource/strategy variables on a residual measure of self-enhancement, obtained by adjusting the comparative judgments for participants' age and objectively measured physical activity. Results. Self-enhancement was positively related to life satisfaction. Perceived control and optimism had shared positive effects on self-enhancement, whereas downward social comparison had a unique positive effect. Discussion. Self-enhancement of physical activity plays a part in at least two adaptive profiles with implications for older adults' well-being and health.
Subject(s)
Adaptation, Psychological , Attitude , Monitoring, Physiologic/psychology , Motor Activity , Personal Satisfaction , Physical Fitness , Quality of Life/psychology , Self Concept , Acceleration , Activities of Daily Living , Aged , Aged, 80 and over , Exercise , Health Behavior , Humans , Judgment , Social Environment , SociologyABSTRACT
OBJECTIVES: The present study of a representative sample of older adults quantified everyday physical activity (EPA) by having participants wear actigraphs. Our objectives were to examine whether poor health may partly explain why older adults become less physically active with advancing age and whether gender might moderate the extent to which health status predicts EPA. METHODS: We performed multiple regression analyses on a sample of older, community-dwelling adults (aged 80-98 years, N = 198; women = 63.1%). RESULTS: The results imply that age-related declines in EPA may be partially accounted for by health (in men) and by living arrangements (in women). DISCUSSION: We consider reasons why poorer health might erode EPA for men (but not women) and why living alone might erode EPA for women (but not men).