医学
甲状腺结节
甲状腺
无症状的
甲状腺功能
甲状腺疾病
甲状腺功能不全
甲状腺癌
甲状腺功能测试
人口
疾病
内分泌系统
重症监护医学
儿科
病理
内科学
激素
环境卫生
作者
José Ignacio Martínez‐Montoro,Viyey Doulatram-Gamgaram,Gabriel Olveira,Sergio Valdés,José Carlos Fernández‐García
标识
DOI:10.1016/j.ejim.2023.06.005
摘要
Thyroid dysfunction is a common endocrine disorder in the general population, with a reported prevalence of 10–15%. However, this rate is even higher in older adults, with an estimated prevalence of ≈25% in some populations. Since elderly patients usually present more comorbidities than younger individuals, thyroid dysfunction may carry a synergistic negative health impact, mainly due to increased cardiovascular disease risk. Moreover, thyroid dysfunction in the elderly can be more difficult to diagnose due to its subtle or even asymptomatic clinical presentation, and the interpretation of thyroid function tests may be affected by drugs that interfere with thyroid function or by the coexistence of several diseases. On the other hand, thyroid nodules are also a prevalent condition in older adults, and its incidence increases with age. The assessment and management of thyroid nodules in the ageing patient should take into account several factors, as risk stratification, thyroid cancer biology, patient´s overall health, comorbidities, treatment preferences, and goals of care. In this review article, we summarize the current knowledge on the pathophysiology, diagnosis, and therapeutic management of thyroid dysfunction in elderly patients and we also review how to identify and manage thyroid nodules in this population.
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