[Thyroid function in the aged admitted to a nursing home]

Intrinsic thyroid diseases and so-called sick euthyroid syndrome are frequent among the elderly. Therefore, we set out to assess the usefulness of the measurement of thyroid hormones and TSH on admission to a public nursing home.A medical history, physical examination, geriatric assessment and a venous sample were taken from 201 elderly subjects on admission to a nursing home. Thyroid hormones and TSH were measured in all cases. All subjects were classified as valid, mentally impaired, or physically impaired, according to the Spanish Red Cross Scales.Sixty non-disabled and 141 disabled elders were studied. Sixteen (7.9%) cases of primary hypothyroidism were found, of whom 7 (3.5%) were deemed deserving treatment with L-thyroxine, their mean daily dose being 114.3 mcg. Sick euthyroid syndrome was considered to be present in 28 (13.9%) cases, of whom 25 had a normal T4, three had a low T4, and none had a high T4. No cases of hyperthyroidism were detected. Thyroid hormone abnormalities were not statistically associated with age, gender, or physical or mental disability.On admission to the nursing home, nearly 8% of the elders have hypothyroidism, and an additional 14% have the sick euthyroid syndrome. Routine measurement of T4 and TSH in elders on admission to a nursing home has a favorable cost-utility ratio.