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Eleanor M. Simonsick, PhD; Anne B. Newman, MD, MPH; Luigi Ferrucci, MD, PhD; Suzanne Satterfield, MD, DrPH; Tamara B. Harris, MD, MS; Nicolas Rodondi, MD, MAS; Douglas C. Bauer, MD; for the Health ABC Study

Arch Intern Med. 2009;169(21):2011-2017.

Background  Health risks associated with subclinical hypothyroidism in older adults are unclear. Our objective was to compare the functional mobility of people aged 70 to 79 years by thyroid function categorized by thyrotropin (TSH) level as euthyroid (0.4 to <4.5 mIU/L), mild subclinical hypothyroid (4.5 to <7.0 mIU/L), or moderate subclinical hypothyroid (7.0 to 20.0 mIU/L with a normal free thyroxine level) cross-sectionally and over 2 years.

Methods  A total of 2290 community-dwelling residents participating in the year 2 clinic visit (July 1998–June 1999) of the Health, Aging, and Body Composition (Health ABC) Study, who had measured TSH level, had the capacity to walk 20 m unaided, and were not taking thyroid medication or had TSH levels consistent with hyperthyroidism or hypothyroidism. Main outcome measures included self-reported and performance-based measures of mobility (usual and rapid gait speed and endurance walking ability) assessed at study baseline (year 2) and 2 years later.

Results  In age- and sex-adjusted analyses, the mild subclinical hypothyroid group (vs the euthyroid group) demonstrated better mobility (faster mean usual and rapid gait speed [1.20 vs 1.15 m/s and 1.65 vs 1.56 m/s, respectively; P < .001] and had a higher percentage of those with good cardiorespiratory fitness and reported walking ease [39.2% vs 28.0% and 44.7% vs 36.5%, respectively; P < .001]). After 2 years, persons with mild subclinical hypothyroidism experienced a similar decline as the euthyroid group but maintained their mobility advantage. Persons with moderate subclinical hypothyroidism had similar mobility and mobility decline as the euthyroid group.

Conclusion  Generally, well-functioning 70- to 79-year-old individuals with subclinical hypothyroidism do not demonstrate increased risk of mobility problems, and those with mild elevations in TSH level show a slight functional advantage.

Author Affiliations: Clinical Research Branch, National Institute on Aging, and Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, Maryland (Drs Simonsick and Ferrucci); Departments of Epidemiology and Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Newman); Department of Preventive Medicine, University of Tennessee, Memphis (Dr Satterfield); Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, Maryland (Dr Harris); Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland (Dr Rodondi); and Department of Medicine, Epidemiology & Biostatistics, University of California, San Francisco (Dr Bauer).

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