DOES AGE PLAY A ROLE IN CLINICAL PRESENTATION OF HYPOTHYROIDISM

OBJECTIVE: To determine if aging modifies the clinical presentation of hypothyroidism. DESIGN: Comparison of 24 clinical signs of hypothyroi dism between elderly patients (greater than or equal to 70 years of ag e) and younger patients (less than or equal to 55 years of age). SETTI NG: Prospective study of patients with chemically confirmed overt hypo thyroidism. PATIENTS: Sixty seven elderly patients (79.3 +/- 6.7 years ) and 54 younger patients (40.8 +/- 9 years) were included in the stud y. RESULTS: Neither mean duration of evolution nor mean thyroid-stimul ating hormone (TSH) level were different between the 2 groups. Two sig ns were found in more than 50% of the elderly patients (fatigue and we akness). Four signs were significantly less frequent in elderly patien ts (chilliness, paresthesiae, weight gain, and cramps). Mean number of clinical signs in the elderly (6.6 +/- 4) was significantly smaller t han in young patients (9.3 +/- 4.7) (P < 0.01). CONCLUSIONS: Our resul ts suggest that the presentation of hypothyroidism is altered in the e lderly in comparison with young patients in that there are (1) fewer s igns or symptoms and (2) diminished frequency of some classical signs. Our results underline the importance of TSH measurement in the elderl y.