Prevalence and Risk Factors of Thyroid Dysfunction in Older Adults in the Community

Sci Rep. 2019 Sep 11;9(1):13156. doi: 10.1038/s41598-019-49540-z.


Prevalence estimates and evidence informing treatment targets for thyroid dysfunction largely come from studies of middle-aged adults. We conducted a cross-sectional analysis to determine the prevalence of thyroid dysfunction and risk factors for abnormal thyroid tests in participants aged ≥65 in the Atherosclerosis Risk in Communities (ARIC) study (N = 5,392). We measured serum concentrations of triiodothyronine (T3), free thyroxine (FT4), thyroid peroxidase antibody (Anti-TPO), and thyroid stimulating hormone (TSH). In this population (58% women, 22% black), 17% reported medication use for thyroid dysfunction. Among those not on treatment, the prevalence of overt and subclinical hypothyroidism was 0.82% and 6.06%, respectively. Overt and subclinical hyperthyroidism affected 0.26% and 0.78%, respectively. Multivariable adjusted TSH, FT4 and T3 levels were 25%, 1.3% and 3.9% lower in blacks compared to whites, respectively. Men were less likely to be anti-TPO positive compared to women (p < 0.001). Former and never smoking were associated with lower T3 and FT4 levels compared to current smoking. The prevalence of thyroid dysfunction in older adults is nearly 25%. Multiple illnesses can interact to contribute to declines in health. Additional attention to thyroid dysfunction and screening in this age group is recommended.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypothyroidism / diagnosis
  • Hypothyroidism / epidemiology
  • Hypothyroidism / physiopathology*
  • Independent Living / statistics & numerical data*
  • Male
  • Prevalence
  • Risk Factors
  • Thyroid Diseases / diagnosis
  • Thyroid Diseases / epidemiology
  • Thyroid Diseases / physiopathology*
  • Thyroid Function Tests
  • Thyroid Gland / metabolism
  • Thyroid Gland / physiopathology*
  • Thyrotropin / blood
  • Thyroxine / blood
  • Triiodothyronine / blood
  • United States / epidemiology


  • Triiodothyronine
  • Thyrotropin
  • Thyroxine