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6. Russell Cherry

Author

Chudley, Sylvia and Parle, Jim

Published
2012

8. Association of Thyroid Dysfunction With Cognitive Function : An Individual Participant Data Analysis

Author

UCL - SSS/IRSS - Institut de recherche santé et société, van Vliet, Nicolien A., van Heemst, Diana, Almeida, Osvaldo P., Åsvold, Bjørn O., Aubert, Carole E., Bae, Jong Bin, Barnes, Linda E., Bauer, Douglas C., Blauw, Gerard J., Brayne, Carol, Cappola, Anne R., Ceresini, Graziano, Comijs, Hannie C., Dartigues, Jean-Francois, Degryse, Jean-Marie, Dullaart, Robin P. F., van Eersel, Marlise E. A., den Elzen, Wendy P. J., Ferrucci, Luigi, Fink, Howard A., Flicker, Leon, Grabe, Hans J., Han, Ji Won, Helmer, Catherine, Huisman, Martijn, Ikram, M. Arfan, Imaizumi, Misa, de Jongh, Renate T., Jukema, J. Wouter, Kim, Ki Woong, Kuller, Lewis H., Lopez, Oscar L., Mooijaart, Simon P., Moon, Jae Hoon, Moutzouri, Elisavet, Nauck, Matthias, Parle, Jim, Peeters, Robin P., Samuels, Mary H., Schmidt, Carsten O., Schminke, Ulf, Slagboom, P. Eline, Stordal, Eystein, Vaes, Bert, Völzke, Henry, Westendorp, Rudi G. J., Yamada, Michiko, Yeap, Bu B., Rodondi, Nicolas, Gussekloo, Jacobijn, Trompet, Stella, UCL - SSS/IRSS - Institut de recherche santé et société, van Vliet, Nicolien A., van Heemst, Diana, Almeida, Osvaldo P., Åsvold, Bjørn O., Aubert, Carole E., Bae, Jong Bin, Barnes, Linda E., Bauer, Douglas C., Blauw, Gerard J., Brayne, Carol, Cappola, Anne R., Ceresini, Graziano, Comijs, Hannie C., Dartigues, Jean-Francois, Degryse, Jean-Marie, Dullaart, Robin P. F., van Eersel, Marlise E. A., den Elzen, Wendy P. J., Ferrucci, Luigi, Fink, Howard A., Flicker, Leon, Grabe, Hans J., Han, Ji Won, Helmer, Catherine, Huisman, Martijn, Ikram, M. Arfan, Imaizumi, Misa, de Jongh, Renate T., Jukema, J. Wouter, Kim, Ki Woong, Kuller, Lewis H., Lopez, Oscar L., Mooijaart, Simon P., Moon, Jae Hoon, Moutzouri, Elisavet, Nauck, Matthias, Parle, Jim, Peeters, Robin P., Samuels, Mary H., Schmidt, Carsten O., Schminke, Ulf, Slagboom, P. Eline, Stordal, Eystein, Vaes, Bert, Völzke, Henry, Westendorp, Rudi G. J., Yamada, Michiko, Yeap, Bu B., Rodondi, Nicolas, Gussekloo, Jacobijn, and Trompet, Stella

Abstract

IMPORTANCE In clinical guidelines, overt and subclinical thyroid dysfunction are mentioned as causal and treatable factors for cognitive decline. However, the scientific literature on these associations shows inconsistent findings. OBJECTIVE To assess cross-sectional and longitudinal associations of baseline thyroid dysfunction with cognitive function and dementia. DESIGN, SETTING, AND PARTICIPANTS This multicohort individual participant data analysis assessed 114 267 person-years (median, 1.7-11.3 years) of follow-up for cognitive function and 525 222 person-years (median, 3.8-15.3 years) for dementia between 1989 and 2017. Analyses on cognitive function included 21 cohorts comprising 38 144 participants. Analyses on dementia included eight cohorts with a total of 2033 cases with dementia and 44 573 controls. Data analysis was performed from December 2016 to January 2021. EXPOSURES Thyroid function was classified as overt hyperthyroidism, subclinical hyperthyroidism, euthyroidism, subclinical hypothyroidism, and overt hypothyroidism based on uniform thyrotropin cutoff values and study-specific free thyroxine values. MAIN OUTCOMES AND MEASURES The primary outcomewas global cognitive function, mostly measured using the Mini-Mental State Examination. Executive function, memory, and dementia were secondary outcomes. Analyses were first performed at study level using multivariable linear regression and multivariable Cox regression, respectively. The studies were combined with restricted maximum likelihood meta-analysis. To overcome the use of different scales, results were transformed to standardized mean differences. For incident dementia, hazard ratios were calculated. RESULTS Among 74 565 total participants, 66 567 (89.3%) participants had normal thyroid function, 577 (0.8%) had overt hyperthyroidism, 2557 (3.4%) had subclinical hyperthyroidism, 4167 (5.6%) had subclinical hypothyroidism, and 697 (0.9%) had overt hypothyroidism. The study-specific median age at basel

Published
2021

9. Association of Thyroid Dysfunction With Cognitive Function An Individual Participant Data Analysis

Author

van Vliet, Nicolien A., van Heemst, Diana, Almeida, Osvaldo P., Asvold, Bjorn O., Aubert, Carole E., Bin Bae, Jong, Barnes, Linda E., Bauer, Douglas C., Blauw, Gerard J., Brayne, Carol, Cappola, Anne R., Ceresini, Graziano, Comijs, Hannie C., Dartigues, Jean-Francois, Degryse, Jean-Marie, Dullaart, Robin P. F., van Eersel, Marlise E. A., den Elzen, Wendy P. J., Ferrucci, Luigi, Fink, Howard A., Flicker, Leon, Grabe, Hans J., Han, Ji Won, Helmer, Catherine, Huisman, Martijn, Ikram, M. Arfan, Imaizumi, Misa, de Jongh, Renate T., Jukema, J. Wouter, Kim, Ki Woong, Kuller, Lewis H., Lopez, Oscar L., Mooijaart, Simon P., Moon, Jae Hoon, Moutzouri, Elisavet, Nauck, Matthias, Parle, Jim, Peeters, Robin P., Samuels, Mary H., Schmidt, Carsten O., Schminke, Ulf, Slagboom, P. Eline, Stordal, Eystein, Vaes, Bert, Volzke, Henry, Westendorp, Rudi G. J., Yamada, Michiko, Yeap, Bu B., Rodondi, Nicolas, Gussekloo, Jacobijn, van Vliet, Nicolien A., van Heemst, Diana, Almeida, Osvaldo P., Asvold, Bjorn O., Aubert, Carole E., Bin Bae, Jong, Barnes, Linda E., Bauer, Douglas C., Blauw, Gerard J., Brayne, Carol, Cappola, Anne R., Ceresini, Graziano, Comijs, Hannie C., Dartigues, Jean-Francois, Degryse, Jean-Marie, Dullaart, Robin P. F., van Eersel, Marlise E. A., den Elzen, Wendy P. J., Ferrucci, Luigi, Fink, Howard A., Flicker, Leon, Grabe, Hans J., Han, Ji Won, Helmer, Catherine, Huisman, Martijn, Ikram, M. Arfan, Imaizumi, Misa, de Jongh, Renate T., Jukema, J. Wouter, Kim, Ki Woong, Kuller, Lewis H., Lopez, Oscar L., Mooijaart, Simon P., Moon, Jae Hoon, Moutzouri, Elisavet, Nauck, Matthias, Parle, Jim, Peeters, Robin P., Samuels, Mary H., Schmidt, Carsten O., Schminke, Ulf, Slagboom, P. Eline, Stordal, Eystein, Vaes, Bert, Volzke, Henry, Westendorp, Rudi G. J., Yamada, Michiko, Yeap, Bu B., Rodondi, Nicolas, and Gussekloo, Jacobijn

Abstract

IMPORTANCE In clinical guidelines, overt and subclinical thyroid dysfunction are mentioned as causal and treatable factors for cognitive decline. However, the scientific literature on these associations shows inconsistent findings.OBJECTIVE To assess cross-sectional and longitudinal associations of baseline thyroid dysfunction with cognitive function and dementia.DESIGN, SETTING, AND PARTICIPANTS This multicohort individual participant data analysis assessed 114 267 person-years (median, 1.7-11.3 years) of follow-up for cognitive function and 525 222 person-years (median, 3.8-15.3 years) for dementia between 1989 and 2017. Analyses on cognitive function included 21 cohorts comprising 38 144 participants. Analyses on dementia included eight cohorts with a total of 2033 cases with dementia and 44 573 controls. Data analysis was performed from December 2016 to January 2021.EXPOSURES Thyroid function was classified as overt hyperthyroidism, subclinical hyperthyroidism, euthyroidism, subclinical hypothyroidism, and overt hypothyroidism based on uniform thyrotropin cutoff values and study-specific free thyroxine values.MAIN OUTCOMES AND MEASURES The primary outcome was global cognitive function, mostly measured using the Mini-Mental State Examination. Executive function, memory, and dementia were secondary outcomes. Analyses were first performed at study level using multivariable linear regression and multivariable Cox regression, respectively. The studies were combined with restricted maximum likelihood meta-analysis. To overcome the use of different scales, results were transformed to standardized mean differences. For incident dementia, hazard ratios were calculated.RESULTS Among 74 565 total participants, 66 567 (89.3%) participants had normal thyroid function, 577 (0.8%) had overt hyperthyroidism, 2557 (3.4%) had subclinical hyperthyroidism, 4167 (5.6%) had subclinical hypothyroidism, and 697 (0.9%) had overt hypothyroidism. The

Published
2021

10. Association of Thyroid Dysfunction with Cognitive Function:An Individual Participant Data Analysis

Author

Van Vliet, Nicolien A., Van Heemst, Diana, Almeida, Osvaldo P., Åsvold, Bjørn O., Aubert, Carole E., Bae, Jong Bin, Barnes, Linda E., Bauer, Douglas C., Blauw, Gerard J., Brayne, Carol, Cappola, Anne R., Ceresini, Graziano, Comijs, Hannie C., Dartigues, Jean Francois, Degryse, Jean Marie, Dullaart, Robin P.F., Van Eersel, Marlise E.A., Den Elzen, Wendy P.J., Ferrucci, Luigi, Fink, Howard A., Flicker, Leon, Grabe, Hans J., Han, Ji Won, Helmer, Catherine, Huisman, Martijn, Ikram, M. Arfan, Imaizumi, Misa, De Jongh, Renate T., Jukema, J. Wouter, Kim, Ki Woong, Kuller, Lewis H., Lopez, Oscar L., Mooijaart, Simon P., Moon, Jae Hoon, Moutzouri, Elisavet, Nauck, Matthias, Parle, Jim, Peeters, Robin P., Samuels, Mary H., Schmidt, Carsten O., Schminke, Ulf, Slagboom, P. Eline, Stordal, Eystein, Vaes, Bert, Völzke, Henry, Westendorp, Rudi G.J., Yamada, Michiko, Yeap, Bu B., Rodondi, Nicolas, Gussekloo, Jacobijn, Trompet, Stella, Van Vliet, Nicolien A., Van Heemst, Diana, Almeida, Osvaldo P., Åsvold, Bjørn O., Aubert, Carole E., Bae, Jong Bin, Barnes, Linda E., Bauer, Douglas C., Blauw, Gerard J., Brayne, Carol, Cappola, Anne R., Ceresini, Graziano, Comijs, Hannie C., Dartigues, Jean Francois, Degryse, Jean Marie, Dullaart, Robin P.F., Van Eersel, Marlise E.A., Den Elzen, Wendy P.J., Ferrucci, Luigi, Fink, Howard A., Flicker, Leon, Grabe, Hans J., Han, Ji Won, Helmer, Catherine, Huisman, Martijn, Ikram, M. Arfan, Imaizumi, Misa, De Jongh, Renate T., Jukema, J. Wouter, Kim, Ki Woong, Kuller, Lewis H., Lopez, Oscar L., Mooijaart, Simon P., Moon, Jae Hoon, Moutzouri, Elisavet, Nauck, Matthias, Parle, Jim, Peeters, Robin P., Samuels, Mary H., Schmidt, Carsten O., Schminke, Ulf, Slagboom, P. Eline, Stordal, Eystein, Vaes, Bert, Völzke, Henry, Westendorp, Rudi G.J., Yamada, Michiko, Yeap, Bu B., Rodondi, Nicolas, Gussekloo, Jacobijn, and Trompet, Stella

Abstract

Importance: In clinical guidelines, overt and subclinical thyroid dysfunction are mentioned as causal and treatable factors for cognitive decline. However, the scientific literature on these associations shows inconsistent findings. Objective: To assess cross-sectional and longitudinal associations of baseline thyroid dysfunction with cognitive function and dementia. Design, Setting, and Participants: This multicohort individual participant data analysis assessed 114267 person-years (median, 1.7-11.3 years) of follow-up for cognitive function and 525222 person-years (median, 3.8-15.3 years) for dementia between 1989 and 2017. Analyses on cognitive function included 21 cohorts comprising 38144 participants. Analyses on dementia included eight cohorts with a total of 2033 cases with dementia and 44573 controls. Data analysis was performed from December 2016 to January 2021. Exposures: Thyroid function was classified as overt hyperthyroidism, subclinical hyperthyroidism, euthyroidism, subclinical hypothyroidism, and overt hypothyroidism based on uniform thyrotropin cutoff values and study-specific free thyroxine values. Main Outcomes and Measures: The primary outcome was global cognitive function, mostly measured using the Mini-Mental State Examination. Executive function, memory, and dementia were secondary outcomes. Analyses were first performed at study level using multivariable linear regression and multivariable Cox regression, respectively. The studies were combined with restricted maximum likelihood meta-analysis. To overcome the use of different scales, results were transformed to standardized mean differences. For incident dementia, hazard ratios were calculated. Results: Among 74565 total participants, 66567 (89.3%) participants had normal thyroid function, 577 (0.8%) had overt hyperthyroidism, 2557 (3.4%) had subclinical hyperthyroidism, 4167 (5.6%) had subclinical hypothyroidism, and 697 (0.9%) had overt hypothyroidism. The study-specific median age at b

Published
2021

11. Comparing physician associates and foundation year two doctors in training undertaking emergency medicine consultations in England : a mixed methods study of processes and outcomes

Author

Halter, Mary, Drennan, Vari, Wang, Chao, Wheeler, Carly, Gage, Heather, Nice, Laura, de Lusignan, Simon, Gabe, Jonathan, Brearley, Sally, Ennis, James, Begg, Philip, and Parle, Jim

Subjects
alliedhealth
Abstract

To compare the contribution of physician associates to the processes and outcomes of emergency medicine consultations with that of foundation year two doctors-in-training. Mixed-methods study: retrospective chart review using 4 months' anonymised clinical record data of all patients seen by physician associates or foundation year two doctors-in-training in 2016; review of a subsample of 40 records for clinical adequacy; semi-structured interviews with staff and patients; observations of physician associates. Three emergency departments in England. The records of 8816 patients attended by 6 physician associates and 40 foundation year two doctors-in-training; of these n=3197 had the primary outcome recorded (n=1129 physician associates, n=2068 doctor); 14 clinicians and managers and 6 patients or relatives for interview; 5 physician associates for observation. The primary outcome was unplanned re-attendance at the same emergency department within 7 days. consultation processes, clinical adequacy of care, and staff and patient experience. Re-attendances within 7 days (n=194 (6.1%)) showed no difference between physician associates and foundation year two doctors-in-training (OR 0.87, 95% CI 0.61 to 1.24, p=0.437). If seen by a physician associate, patients were more likely receive an X-ray investigation (OR 2.10, 95% CI 1.72 to 4.24), p

Published
2020

13. Comparing physician associates and foundation year two doctors-in-training undertaking emergency medicine consultations in England: a mixed-methods study of processes and outcomes

Author

Halter, Mary, primary, Drennan, Vari, additional, Wang, Chao, additional, Wheeler, Carly, additional, Gage, Heather, additional, Nice, Laura, additional, de Lusignan, Simon, additional, Gabe, Jonathan, additional, Brearley, Sally, additional, Ennis, James, additional, Begg, Phil, additional, and Parle, Jim, additional

Published
2020
Full Text
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23. Association of Thyroid Dysfunction With Cognitive Function: An Individual Participant Data Analysis

Author

van Vliet, Nicolien A, van Heemst, Diana, Almeida, Osvaldo P, Åsvold, Bjørn O, Aubert, Carole E., Bae, Jong Bin, Barnes, Linda E, Bauer, Douglas C, Blauw, Gerard J, Brayne, Carol, Cappola, Anne R, Ceresini, Graziano, Comijs, Hannie C, Dartigues, Jean-Francois, Degryse, Jean-Marie, Dullaart, Robin P F, van Eersel, Marlise E A, den Elzen, Wendy P J, Ferrucci, Luigi, Fink, Howard A, Flicker, Leon, Grabe, Hans J, Han, Ji Won, Helmer, Catherine, Huisman, Martijn, Ikram, M Arfan, Imaizumi, Misa, de Jongh, Renate T, Jukema, J Wouter, Kim, Ki Woong, Kuller, Lewis H, Lopez, Oscar L, Mooijaart, Simon P, Moon, Jae Hoon, Moutzouri, Elisavet, Nauck, Matthias, Parle, Jim, Peeters, Robin P, Samuels, Mary H, Schmidt, Carsten O, Schminke, Ulf, Slagboom, P Eline, Stordal, Eystein, Vaes, Bert, Völzke, Henry, Westendorp, Rudi G J, Yamada, Michiko, Yeap, Bu B, Rodondi, Nicolas, Gussekloo, Jacobijn, and Trompet, Stella

Subjects
endocrine system, endocrine system diseases, 610 Medicine & health, 360 Social problems & social services, 3. Good health
Abstract

Importance In clinical guidelines, overt and subclinical thyroid dysfunction are mentioned as causal and treatable factors for cognitive decline. However, the scientific literature on these associations shows inconsistent findings. Objective To assess cross-sectional and longitudinal associations of baseline thyroid dysfunction with cognitive function and dementia. Design, Setting, and Participants This multicohort individual participant data analysis assessed 114 267 person-years (median, 1.7-11.3 years) of follow-up for cognitive function and 525 222 person-years (median, 3.8-15.3 years) for dementia between 1989 and 2017. Analyses on cognitive function included 21 cohorts comprising 38 144 participants. Analyses on dementia included eight cohorts with a total of 2033 cases with dementia and 44 573 controls. Data analysis was performed from December 2016 to January 2021. Exposures Thyroid function was classified as overt hyperthyroidism, subclinical hyperthyroidism, euthyroidism, subclinical hypothyroidism, and overt hypothyroidism based on uniform thyrotropin cutoff values and study-specific free thyroxine values. Main Outcomes and Measures The primary outcome was global cognitive function, mostly measured using the Mini-Mental State Examination. Executive function, memory, and dementia were secondary outcomes. Analyses were first performed at study level using multivariable linear regression and multivariable Cox regression, respectively. The studies were combined with restricted maximum likelihood meta-analysis. To overcome the use of different scales, results were transformed to standardized mean differences. For incident dementia, hazard ratios were calculated. Results Among 74 565 total participants, 66 567 (89.3%) participants had normal thyroid function, 577 (0.8%) had overt hyperthyroidism, 2557 (3.4%) had subclinical hyperthyroidism, 4167 (5.6%) had subclinical hypothyroidism, and 697 (0.9%) had overt hypothyroidism. The study-specific median age at baseline varied from 57 to 93 years; 42 847 (57.5%) participants were women. Thyroid dysfunction was not associated with global cognitive function; the largest differences were observed between overt hypothyroidism and euthyroidism-cross-sectionally (-0.06 standardized mean difference in score; 95% CI, -0.20 to 0.08; P = .40) and longitudinally (0.11 standardized mean difference higher decline per year; 95% CI, -0.01 to 0.23; P = .09). No consistent associations were observed between thyroid dysfunction and executive function, memory, or risk of dementia. Conclusions and Relevance In this individual participant data analysis of more than 74 000 adults, subclinical hypothyroidism and hyperthyroidism were not associated with cognitive function, cognitive decline, or incident dementia. No rigorous conclusions can be drawn regarding the role of overt thyroid dysfunction in risk of dementia. These findings do not support the practice of screening for subclinical thyroid dysfunction in the context of cognitive decline in older adults as recommended in current guidelines.

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