الفهرس 
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Abstract
Adequate thyroid function is essential for normal development and retention of cognitive function throughout life. As age advances, the thyroid gland undergoes progressive fibrosis and atrophy.
In the elderly, the diagnosis of thyroid dysfunction is more often overlooked or misdiagnosed, as the symptoms are often subtle or absent and are easily confused with coexisting illnesses or mistaken as age-related changes. High index of suspicion of thyroid dysfunction in the elderly is needed.
This study was conducted on one group of 230 older adults aged 65 years old and above who were attending Geriatric outpatient clinic or admitted to the Geriatric Unit, Internal Medicine Department, Alexandria Main University Hospital. Patients with chronic renal disease, liver failure, severe dementia and thyroid malignancy were excluded.
The aim of the current study was to estimate the prevalence of thyroid dysfunction in older adults and to determine the association between thyroid dysfunction in older adults, mental health and quality of life.
Regarding gender, among the studied group (n=230), 26.1% (n=60) were males and 73.9% (n=170) were females.
Regarding age, among the studied group (n= 230), 77.4% (n=178) were young old (65- 74 years old), 18.3% (n=42) were old (75-84 years old) and only 4.3% (n=10) were very old (≥ 85 years old).The mean age of the studied group was (69.63 ± 6.34).
Among the studied group (n = 230), 64.3% (n = 148) were euthyroid, 23.5 % (n=54) were overtly hypothyroid, 4.3% (n=10) were subclinically hypothyroid, 6.1 % (n=14) were overtly hyperthyroid and only 1.7% (n=4) were subclinically hyperthyroid.
Among males (n=60), 80% (n=48) were euthyroid and among females (n= 170), 58.8% were euthyroid. This difference was statistically significant. (p= 0.003).
Among males (n=60), 10% (n=6) were overtly hypothyroid, 0% (n=0) were subclinically hypothyroid and among females (n= 170), 28.2% (n=48) were overtly hypothyroid and 5.9% (n=10) were subclinically hypothyroid. However this difference was not statistically significant (p= 0.578).
Among males (n=60), 6.7 % (n=4) were overtly hyperthyroid, 3.3% (n=2) were subclinically hyperthyroid and among females (n= 170), 5.9% (n=10) were overtly hyperthyroid and 1.2% (n=2) were subclinically hyperthyroid. This difference was not statistically significant (p= 0.569).
Among young old (n=178), 58.4% (n=104) were euthyroid, among old (n=42), 81.0% (n=34) were euthyroid, however among very old (n=10), 100.0% (n =10) were euthyroid. This difference was statistically significant. (p= 0.001).
Among young old (n=178), 29.2% (n=52) were overtly hypothyroid, 4.5% (n=8) were subclinically hypothyroid, among old (n=42), 4.8% (n=2) were overtly hypothyroid and also 4.8% (n=2) were subclinically hypothyroid, however among very old (n=10), 0.0% (n =0.0) were overtly hypothyroid and also 0.0% (n=0.0) were subclinically hypothyroid. This difference was not statistically significant. (p= 0.112).
Among young old (n=178), 6.7% (n=12) were overtly hyperthyroid, 1.1% (n=2) were subclinically hyperthyroid, among old (n=42) 4.8% (n=2) were overtly hyperthyroid also and 4.8% (n=2) were subclinically hyperthyroid, however among very old (n=10), 0.0% (n =0.0) were overtly hyperthyroid and also 0.0% (n =0.0) were subclinically hyperthyroid. This difference was not statistically significant (p= 0.197).
Among the euthyroid group (n=148), 44.6% (n=66) were having marked cognitive dysfunction compared to 59.4% (n=38) of the hypothyroid group (n=64) and 44.4% (n=8) of the hyperthyroid group (n= 18), however this difference was not statistically significant. (p value= 0.111).
Among the euthyroid group (n=148), nearly more than half of the cases 52.7%, (n=78) were depressed as compared to 66.7% (n=12) of the hyperthyroid group (n=18), on the other hand the majority of the hypothyroid group (n=64), 90.6% (n =58) were depressed. This difference was statistically significant. (p value <0.001).
Among the overtly hypothyroid group (n=54), 63.0% (n=34) were having marked cognitive dysfunction compared to 40.0% (n=4) of the subclinically hypothyroid group (n=10). This difference was not statistically significant. (p=0.312).
Among the overtly hypothyroid group (n=54), 92.6% (n=50) were depressed compared to 80.0% (n=8) of the subclinically hypothyroid group (n=10). This difference was not statistically significant. (p=0.234).
Among the overtly hyperthyroid group (n=14), 57.1% (n=8) were having marked cognitive dysfunction compared to 0.0% (n=0) of the subclinically hyperthyroid group (n=4). This difference was not statistically significant. (p=0.077).
Among the overtly hyperthyroid group (n=14), 71.4 % (n=10) were depressed compared to 50.0% (n=2) of the subclinically hypothyroid group (n=4). This difference was not statistically significant. (p=0.569).
Regarding physical functioning score, the mean score was higher among the euthyroid group (30.07 ± 21.81) as compared to both the hypothyroid (19.22±14.81) and the hyperthyroid (25.56±11.23) groups, moreover the mean physical functioning score among the hyperthyroid group was higher than the hypothyroid group. This difference was statistically significant. (p=0.003).