Sex-modulated association between thyroid stimulating hormone and informant-perceived anxiety in non-depressed older adults: prediction models and relevant cutoff value

Abstract

AbstractHighlightsLower TSH levels predicted higher odds of anxiety in non-depressed older adults.The association between TSH and anxiety was significant in older males but not in older females.TSH level corresponding to 2.4 µIU/mL was a significant cutoff value in this association, under which thyroid function predicted significantly higher odds of anxiety in older males.Only in older males, but not older females, TSH levels were significantly lower in those with anxiety than in those without.IntroductionThe aim of this study was to assess the association between thyroid function and perceived anxiety in non-depressed older adults.MethodsNon-depressed Alzheimer’s Disease Neuroimaging Initiative participants with complete Thyroid Stimulating Hormone (TSH) and neuropsychiatric inventory (NPI/NPI-Q) were included. The association between anxiety and thyroid function was assessed by logistic regression and sex stratification. Restricted cubic splines were applied to evaluate non-linearity in the association.ResultsThe median age of 2,114 eligible participants was 73 years (68-78), 1,117 (52.84%) were males, and the median TSH was 1.69µIU/mL. There was a significant association between TSH and informant-perceived anxiety in the total study population (ORModel1=0.86, 95%CI 0.76-0.97, p=0.011), even after adjusting for bio-demographical (adj.ORModel2=0.85, 95%CI 0.75-0.96, p=0.007), and socio-cognitive confounders (adj.ORModel3=0.84, 95%CI 0.73-0.96, p=0.009). Sex-stratification showed similar significant results in all models only in males (ORModel1-male=0.71, 95%CI: 0.58-0.85,pModel1-male<0.001). In the general population and males, a TSH value of 2.4µIU/dL was a significant cutoff under which anxiety odds were significantly high, even after adjusting for confounders.ConclusionsThe sex-dependent association between TSH levels and perceived anxiety in non-depressed older adults is a novel finding that has to be further explored for a better understanding of the underlying neurobehavioral biology.Abstract Figure