Vol 68, No 3 (2017)
Original paper
Published online: 2017-06-01

open access

Page views 1660
Article views/downloads 1622
Get Citation

Connect on Social Media

Connect on Social Media

Models of cognitive functions with respect to selected parameters of functional state of the thyroid gland in post-menopausal women

Mariusz Gujski, Jarosław Pinkas, Mariusz Witczak, Alfred Owoc1, Iwona Bojar
Pubmed: 28660996
Endokrynol Pol 2017;68(3):290-298.

Abstract

Introduction: The objective of the study was the development of models of cognitive functions in a group of post-menopausal women, according to the concentration of the selected laboratory parameters evaluating the functional state of the thyroid gland.

Material and methods: The study was conducted during 2012–2014, and covered women aged 50–65 years, minimum two years after the last menstruation, without chronic diseases, cancerous diseases, mental disorders, addiction to drugs or alcohol, and who did not use hormone replacement therapy. At the stage of qualification, a brief MoCA test was performed; 383 women were qualified for the study. Blood was collected for the determination of such parameters as: TSH, TT4, fT4, anti-TPO, anti-Tg, and AB-TSHR. Assessment of cognitive functions was performed using the diagnostic instrument Central Nervous System — Vital Signs (CNS-VS) (Polish version). The results were statistically analysed.

Results: The mean age of the women in the study was 56.4 ± 3.4; the mean TSH was 1.91 ± 1.35 mU/L, fT4 14.76 ± 2.34 pmol/L, and TT4 99.12 ± 16.98 nmol/L. Mean values were: 64.74 IU/L for anti-TPO, 100.69 IU/L for anti-Tg, and 1.40 IU/L for AB-TSHR. The examined women obtained the neurocognitive index (NCI) on the level of 84.4 scores, on average. The lowest results were obtained in tests assessing cognitive flexibility (mean 78.64 scores), processing speed (mean 79.25 scores), and executive functions (mean 79.75 scores). In the tests evaluating complex attention, the mean values were 82.24 scores, psychomotor speed — mean 83.42 scores, and reaction time — mean 86.87 scores. The women examined obtained the best results in tests assessing memory (mean 90.15 scores), including verbal (mean 91.22 scores), and visual (mean 93.37 scores). The NCI and cognitive function models were assessed from the aspect of thyroid gland examinations in post-menopausal women. Based on the analyses performed, the following conclusions were drawn: The developed models of cognitive functions indicate a considerable effect of TSH, fT4, AB-TSHR, and anti-TPO, as well as TT4 and anti-Tg, on the level of cognitive functions after menopause in the group examined. The conducted study suggests the need for examination of the functional state of the thyroid gland in post-menopausal women who show cognitive function disorders.

References

  1. EUROSTAT Eurostat database Available at:http://epp eurostat ec europa eu. rostat..ropa..
  2. Witkowski J (przew.). Rocznik Demograficzny. Główny Urząd Statystyczny, Warszawa 2012; 62: 404,490,518-521.
  3. Stachowiak G, Pertyński T, Pertyńska-Marczewska M. Effect of transdermal hormone therapy on platelet haemostasis in menopausal women. Ann Agric Environ Med. 2015; 22(1): 167–171.
  4. Humeniuk E, Bojar I, Owoc A, et al. Psychosocial conditioning of depressive disorders in post-menopausal women. Ann Agric Environ Med. 2011; 18(2): 441–445.
  5. Bojar I, Wojcik-Fatla A, Owoc A, et al. Polymorphisms of apolipoprotein E gene and cognitive functions of postmenopausal women, measured by battery of computer tests - Central Nervous System Vital Signs. Neuro Endocrinol Lett. 2012; 33(4): 385–392.
  6. Milewicz A. Fizjologiczne i endokrynologiczne aspekty okresu klimakterium. W:Endokrynologia kliniczna. Milewicz A (red.). Polskie Towarzystwo Endokrynologiczne, Wrocław 2012; T 3: 66–67.
  7. Kaczmarek M. Określenie wieku menopauzy naturalnej w populacji polskich kobiet. Prz Menop. 2007; 2: 77–82.
  8. Robak-Chołubek D, Wdowiak A, Makara-Studzińska M, et al. Perception and degree of acceptance of menopause-related changes in various spheres of life by postmenopausal women. Ann Agric Environ Med. 2014; 21(3): 666–669.
  9. Janiszewska M, Firlej E, Dziedzic M, et al. Health beliefs and sense of one's own efficacy and prophylaxis of osteoporosis in peri- and post-menopausal women. Ann Agric Environ Med. 2016; 23(1): 167–173.
  10. Bégin ME, Langlois MF, Lorrain D, et al. Thyroid Function and Cognition during Aging. Curr Gerontol Geriatr Res. 2008: 474868.
  11. Bojar I, Wierzbińska-Stępniak A, Witczak M, et al. Are cognitive functions in post-menopausal women related with the contents of macro- and micro-components in the diet? Ann Agric Environ Med. 2015; 22(1): 178–184.
  12. Colzato LS, Pratt J, Hommel B. Estrogen modulates inhibition of return in healthy human females. Neuropsychologia. 2012; 50(1): 98–103.
  13. Bowers JM, Waddell J, McCarthy MM. A developmental sex difference in hippocampal neurogenesis is mediated by endogenous oestradiol. Biol Sex Differ. 2010; 1(1): 8.
  14. Carroll JC, Rosario ER. The potential use of hormone-based therapeutics for the treatment of Alzheimer's disease. Curr Alzheimer Res. 2012; 9(1): 18–34.
  15. Yaffe K, Vittinghoff E, Ensrud KE, et al. Effects of ultra-low-dose transdermal estradiol on cognition and health-related quality of life. Arch Neurol. 2006; 63(7): 945–950.
  16. LaCroix AZ, Chlebowski RT, Manson JE, et al. WHI Investigators. Health outcomes after stopping conjugated equine estrogens among postmenopausal women with prior hysterectomy: a randomized controlled trial. JAMA. 2011; 305(13): 1305–1314.
  17. Grady D, Yaffe K, Kristof M, et al. Effect of postmenopausal hormone therapy on cognitive function: the Heart and Estrogen/progestin Replacement Study. Am J Med. 2002; 113(7): 543–548.
  18. Dąbkowska M, Augustyńska B, Odrowąż-Sypniewska G, et al. Poziom hormonu tyreotropowego a wybrane funkcje poznawcze u chorych na schizofrenię. Postępy Psychiatrii i Neurologii. 2008; 17(1): 29–33.
  19. Bauer M, Heinz A, Whybrow PC. Thyroid hormones, serotonin and mood: of synergy and significance in the adult brain. Mol Psychiatry. 2002; 7(2): 140–156.
  20. Derkacz M, Michałojc-Derkacz M, Chmiel-Perzyńska I, et al. Michałojc-, , Zaburzenia psychiczne a nadczynność tarczycy. Curr Probl Psychiatry. 2011; 12(2): 146–151.
  21. del Ghianda S, Tonacchera M, Vitti P. Thyroid and menopause. Climacteric. 2014; 17(3): 225–234.
  22. Magierska J, Magierski R, Fendler W, et al. Clinical application of the Polish adaptation of the Montreal Cognitive Assessment (MoCA) test in screening for cognitive impairment. Neurol Neurochir Pol. 2012; 46(2): 130–139.
  23. Gualtieri CT, Johnson LG. Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs. Arch Clin Neuropsychol. 2006; 21(7): 623–643.
  24. European Communities. Data Information on Women’s Health In the European Union. Dresden 2009.
  25. Alzheimer’s Association. Alzheimer’s disease facts and figures. 2012. www.alz.org/downloades/Facts_Figures_2012.pdf.
  26. Carter CL, Resnick EM, Mallampalli M, et al. Sex and gender differences in Alzheimer's disease: recommendations for future research. J Womens Health (Larchmt). 2012; 21(10): 1018–1023.
  27. Rapp SR, Legault C, Henderson VW, et al. Subtypes of mild cognitive impairment in older postmenopausal women: the Women's Health Initiative Memory Study. Alzheimer Dis Assoc Disord. 2010; 24(3): 248–255.
  28. Greendale GA, Huang MH, Wight RG, et al. Effects of the menopause transition and hormone use on cognitive performance in midlife women. Neurology 2009; 72: 1850-1857.
  29. Roberts LM, Pattison H, Roalfe A, et al. Is subclinical thyroid dysfunction in the elderly associated with depression or cognitive dysfunction? Ann Intern Med. 2006; 145(8): 573–581.
  30. Beydoun MA, Beydoun HA, Kitner-Triolo MH, et al. Thyroid hormones are associated with cognitive function: moderation by sex, race, and depressive symptoms. J Clin Endocrinol Metab. 2013; 98(8): 3470–3481.
  31. Hogervorst E, Huppert F, Matthews FE, et al. Thyroid function and cognitive decline in the MRC Cognitive Function and Ageing Study. Psychoneuroendocrinology. 2008; 33(7): 1013–1022.
  32. Choi SM, Kim BC, Choi KH, et al. Thyroid status and cognitive function in euthyroid patients with early Parkinson's disease. Dement Geriatr Cogn Disord. 2014; 38(3-4): 178–185.
  33. Gunnarsson T, Sjöberg S, Eriksson M, et al. Depressive symptoms in hypothyroid disorder with some observations on biochemical correlates. Neuropsychobiology. 2001; 43(2): 70–74.
  34. van Boxtel MPJ, Menheere PP, Bekers O, et al. Thyroid function, depressed mood, and cognitive performance in older individuals: the Maastricht Aging Study. Psychoneuroendocrinology. 2004; 29(7): 891–898.
  35. Gan EH, Pearce SHS. Clinical review: The thyroid in mind: cognitive function and low thyrotropin in older people. J Clin Endocrinol Metab. 2012; 97(10): 3438–3449.
  36. Chachamovitz DS, Vigário PD, Silva SO, et al. Does low-normal serum TSH level adversely impact cognition in elderly adults and might methimazole therapy improve outcomes? Endocr J. 2016; 63(5): 495–505.
  37. Moon JH, Park YJ, Kim TH, et al. Lower-but-normal serum TSH level is associated with the development or progression of cognitive impairment in elderly: Korean Longitudinal Study on Health and Aging (KLoSHA). J Clin Endocrinol Metab. 2014; 99(2): 424–432.
  38. Wijsman LW, de Craen AJM, Trompet S, et al. Subclinical thyroid dysfunction and cognitive decline in old age. PLoS One. 2013; 8(3): e59199.
  39. Ojala AK, Schalin-Jäntti C, Pitkälä KH, et al. Serum thyroid-stimulating hormone and cognition in older people. Age Ageing. 2016; 45(1): 155–157.
  40. Laurberg P, Andersen S, Bülow Pedersen I, et al. Hypothyroidism in the elderly: pathophysiology, diagnosis and treatment. Drugs Aging. 2005; 22(1): 23–38.
  41. Resta F, Triggiani V, Barile G, et al. Subclinical hypothyroidism and cognitive dysfunction in the elderly. Endocr Metab Immune Disord Drug Targets. 2012; 12(3): 260–267.
  42. Ceresini G, Lauretani F, Maggio M, et al. Thyroid function abnormalities and cognitive impairment in elderly people: results of the Invecchiare in Chianti study. J Am Geriatr Soc. 2009; 57(1): 89–93.
  43. Grigorova M, Sherwin BB. Thyroid hormones and cognitive functioning in healthy, euthyroid women: a correlational study. Horm Behav. 2012; 61(4): 617–622.
  44. Mizuma A, Goto Y, Takahashi W, et al. A Patient with Hashimoto's Encephalopathy Presenting with Convulsive Seizure Alone as the Initial Symptom. Clin Med Insights Case Rep. 2013; 6: 75–77.
  45. Nayak HK, Daga MK, Kumar R, et al. A series report of autoimmune hypothyroidism associated with Hashimoto's encephalopathy: an under diagnosed clinical entity with good prognosis. BMJ Case Rep. 2010; 2010.
  46. Regal PJ. Antithyroid antibodies, cognition and instrumental activities of daily living in the elderly. Int J Geriatr Psychiatry. 2012; 27(12): 1317–1318.
  47. Jabłkowska K. Karbownik-Lewińska M. Nowakowska K. Junik R. Lewiński A. Borkowska A. Pamięć operacyjna i funkcje wykonawcze w nadczynności tarczycy w przebiegu choroby Gravesa i Basedowa. Psychiatria Polska 2008; XLII. ; 2: 249–259.