PMID: 8604186Feb 19, 1996Paper

Hyperthyroidism in elderly hospitalised patients. Clinical features and treatment outcomes

The Medical Journal of Australia
F I Martin, D R Deam

Abstract

To review the clinical features and response to treatment of hyperthyroidism in elderly hospitalised patients. Sixty patients over the age of 70: 41 admitted to a geriatric hospital and 19 to an acute-care hospital, 1990-1993. Thyroid function tests were performed routinely in the geriatric hospital but only on demand at the acute-care hospital. Hyperthyroidism was defined as elevation of plasma free thyroxine (FT4) or total tri-iodothyronine (T3) level and suppression of thyroid-stimulating hormone (TSH) level. Seventy-seven per cent of patients were seen personally; in the remainder details were obtained from their hospital records. Outcome was assessed by clinical and biochemical improvement. Clinical features - Fifty-two women and eight men with hyperthyroidism were identified. Their average age was 80.2 years (range, 70-101; median, 80.0). The most common clinical features were weight loss (83%) and atrial fibrillation (60%); 58% were agitated and 15% apathetic. Fifty-two per cent had cognitive impairment with either dementia or confusion. The diagnosis was not initially suspected in 62%. Thyroid antibodies were absent in 35/40 and an isotope scan showed a nodular thyroid in 27/29. Contrast radiography with iodine-containi...Continue Reading

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