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Endocrinology

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Geriatrics for Specialists

Abstract

Endocrine conditions, type 2 diabetes, obesity, hypothyroidism, hypogonadism, and osteoporosis are prevalent in the geriatric population. Endocrinologist and other practitioners face challenges in the management of both new and long-standing patients with these problems.

Recent clinical guidelines propose using age-adjusted targets and approaches, watchful waiting, care coordination, and addressing social support or lack thereof. The decline of physical and cognitive function, depression, polypharmacy, and quality of life are increasingly emphasized in the endocrine literature about the care of older patients.

This chapter focuses on the most prevalent endocrine conditions among older adults and brings relevant geriatric principles in the context of available literature and recommendations.

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References

  1. American Diabetes Association. Fast facts data and statistics about diabetes. March, 2015. Available at http://professional.diabetes.org/admin/UserFiles/0%20-%20Sean/14_fast_facts_june2014_final3.pdf. Accessed 8 Oct 2015.

  2. Centers for Disease Prevention and Control. Incidence of diagnosed diabetes per 1,000 population aged 18-79 years, by age, United States, 1980-2014. Available at http://www.cdc.gov/diabetes/statistics/incidence/fig3.htm. Accessed 8 Oct 2015.

  3. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2014. Available at http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf. Accessed 8 Oct 2015.

  4. Centers for Disease Control and Prevention. National Diabetes Statistics Report: estimates of diabetes and its burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services; 2014. Available at http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf. Accessed 8 Oct 2015.

  5. Kirkman SM, Briscoe VJ, Clark N, et al. Diabetes in older adults. Diabetes Care. 2012;35:2650–64.

    Article  PubMed  PubMed Central  Google Scholar 

  6. American Diabetes Association. Older adults. Sec 10. In standards of Medical care in Diabetes – 2015. Diabetes Care 2015;38(Suppl 1):S67–S9.

    Google Scholar 

  7. Valencia WM, Florez H. Pharmacological treatment of diabetes in older people. Diabetes Obes Metab. 2014;16(12):1192–203.

    Article  CAS  PubMed  Google Scholar 

  8. Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach. Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38:140–9.

    Article  PubMed  Google Scholar 

  9. American Geriatrics Society. Guiding principles for the care of older adults with multimorbidity: an approach for clinicians. American Geriatrics Society Expert Panel on the care of older adults with multimorbidity. J Am Geriatr Soc. 2012;60(10):E1–E25.

    Article  Google Scholar 

  10. Huang ES, Laiteerapong N, Liu JY, et al. Rates of complications and mortality in older patients with diabetes mellitus. The diabetes and aging study. JAMA Inter Med. 2014;174(2):251–8.

    Article  Google Scholar 

  11. Strotmeyer ES. Diabetes and aging. Clin Geriatr Med 2015;31(1):xiii–xvi.

    Google Scholar 

  12. American Diabetes Association. Initial evaluation and diabetes management planning. Sec 3. In standards of Medical care in Diabetes – 2015. Diabetes Care 2015;38(Suppl 1):S17–S9.

    Google Scholar 

  13. Sinclair A, Morley JE, Rodriguez-Manas L, et al. Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for older people (EDWPOP), and the International Task Force of Experts in Diabetes. J Am Med Dir Assoc. 2012;13:497–502.

    Article  PubMed  Google Scholar 

  14. Lin J, Zhou S, Wei W, Pan C, Lingohr-Smith M, Levin P. Does clinical inertia vary by personalized A1c goal? A study of predictors and prevalence of clinical inertia in a US managed care setting. Endocr Pract. 2015. [Epub ahead of print].

    Google Scholar 

  15. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403.

    Article  PubMed Central  Google Scholar 

  16. Diabetes Prevention Program Research Group, Crandall J, Schade D, et al. The influence of age on the effects of lifestyle modification and metformin in prevention of diabetes. J Gerontol A Biol Sci Med Sci. 2006;61(1):1075–81.

    Google Scholar 

  17. Garber AJ, Abrahamson MJ, Barzilay JI, et al. AACE/ACE comprehensive diabetes management algorithm 2015. Endocr Pract. 2015;21(4):438–47.

    Article  PubMed  Google Scholar 

  18. The Action to Control Cardiovascular Risk in Diabetes Study Group. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. 2008;368(24):2545–59.

    Google Scholar 

  19. The ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560–72.

    Article  Google Scholar 

  20. Duckworth WC, Abraira C, Moritz T, et al. Glucose control and vascular complications in Veterans with type 2 diabetes. N Eng J Med. 2009;360:129–39.

    Article  CAS  Google Scholar 

  21. American Geriatrics Society Expert Panel on the Care of Older Adults with Diabetes Mellitus. Guidelines abstracted from the American Geriatrics Society guidelines for improving the care of older adults with diabetes mellitus: 2013 Update. J Am Geriatr Soc. 2013;61:2020–26

    Google Scholar 

  22. The American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63:2227–46.

    Google Scholar 

  23. Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: clinical, research and policy implications of a core geriatric concept. J Am Geriatr Soc. 2007;55(5):780–91.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Munshi M. Managing the “geriatric syndrome” in patients with type 2 diabetes. Consult Pharm. 2008;23(Suppl B):12–6.

    PubMed  Google Scholar 

  25. Boyd CM, Darer J, Boult C, et al. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA. 2005;294(60):716–24.

    Article  CAS  PubMed  Google Scholar 

  26. Peron EP, Ogbonna KC, Donohoe KL. Antidiabetic medications and polypharmacy. Clin Geriatr Med. 2015;31:17–27.

    Article  PubMed  Google Scholar 

  27. Wu Q, Tchetgen Tchetgen EJ, Qsypuk T, et al. Estimating the cognitive effects of prevalent diabetes, recent onset diabetes, and the duration of diabetes among older adults. Dement Geriatr Cogn Disord. 2015;39:239–49.

    Article  PubMed  Google Scholar 

  28. Bangen KJ, Gu Y, Gross AL, et al. Relationship between type 2 diabetes mellitus and cognitive change in a multiethnic elderly cohort. J Am Geriatr Soc. 2015;63:1075–83.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Rawlings AM, Sharrett AR, Schneider ALC, et al. Diabetes in midlife and cognitive change over 20 years. A cohort study. Ann Intern Med. 2014;161:785–93.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Feinkohl I, Aung PP, Keller M, et al. Severe hypoglycemia and cognitive decline in older people with type 2 diabetes: the Edinburg type 2 diabetes study. Diabetes Care. 2014;37:507–15.

    Article  CAS  PubMed  Google Scholar 

  31. Launer LJ, Miller ME, Williamson JD, et al. Effects of intensive glucose lowering on brain structure and function in people with type 2 diabetes (ACCORD MIND): a randomized open-label substudy. Lancet Neurol. 2011;10:969–77.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Espeland MA, Rapp SR, Bray GA, et al. Long-term impact of behavioral weight loss intervention on cognitive function. J Gerontol A Biol Sci Med Sci. 2014;69(9):1101–8.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Whitmer RA, Karter AJ, Yaffe K, Quesenberry CPJ, Selby JV. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes. JAMA. 2009;301:1565–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Punthakee Z, Miller ME, Launer LE, et al. Poor cognitive function and risk of severe hypoglycemia in type 2 diabetes. Diabetes Care. 2012;35:787–93.

    Article  PubMed  PubMed Central  Google Scholar 

  35. CDC overweight and obesity facts. Centers for Disease Control and Prevention. 2014. Available at. http://www.cdc.gov/obesity/data/adult.html. Accessed 8 Oct 2015.

  36. Valencia WM, Stoutenberg M, Florez H. Weight loss and physical activity for disease prevention in obese older adults: an important role for lifestyle management. Curr Diab Rep. 2014;14:539–48.

    Article  PubMed  Google Scholar 

  37. Loef M, Walach H. Midlife obesity and dementia: meta-analysis and adjusted forecast of dementia prevalence in the United States and China. Obesity. 2013;21:E51–5.

    Article  PubMed  Google Scholar 

  38. WHO Global strategy on diet, physical activity and health. Obesity and overweight facts. World Health Organization. 2003. Available at http://www.who.int/dietphysicalactivity/media/en/gsfs_obesity.pdf. Accessed 8 Oct 2015.

  39. The Obesity Society. Obesity, bias and stigmatization. Available at http://www.obesity.org/resources/facts-about-obesity/bias-stigmatization. Accessed 8 Oct 2015.

  40. Carnethon MR, De Chavez PJD, Biggs ML, et al. Association of weight status with mortality in adults with incident diabetes. JAMA. 2012;308:581–90.

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Lavie CJ, McAuley PA, Church TS, Milani RV, Blair SN. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox. J Am Coll Cardiol. 2014;63:1345–54.

    Article  PubMed  Google Scholar 

  42. Hainer V, Aldhoon-Hainerová I. Obesity paradox does exist. Diabetes Care. 2013;36 Suppl 2:S276–81.

    Article  PubMed  PubMed Central  Google Scholar 

  43. McAuley PA, Beavers KM. Contribution of cardiorespiratory fitness to the obesity paradox. Prog Cardiovasc Dis. 2014;56:434–40.

    Article  PubMed  Google Scholar 

  44. Barry VW, Baruth M, Beets MW, Durstine JL, Liu J, Blair SN. Fitness vs fatness on all-cause mortality: a meta-analysis. Prog Cardiovasc Dis. 2014;56:382–90.

    Article  PubMed  Google Scholar 

  45. Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA. Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet. 1999;353(9156):878–82.

    Article  CAS  PubMed  Google Scholar 

  46. Kannegaard PN, van derMark S, Eiken P, Abrahamsen B. Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival. Age Ageing. 2010;39(2):203–9.

    Article  PubMed  Google Scholar 

  47. Rizzoli R, Branco J, Brandi ML, et al. Management of osteoporosis in the oldest old. Osteoporos Int. 2014;25:2507–29.

    Article  CAS  PubMed  Google Scholar 

  48. Chevalley T, Guilley E, Hermann FR, Hoffmeyer P, Rapin CH, Rizzoli R. Incidence of hip fracture over a 10-year period (1991-2000): reversal of a secular trend. Bone. 2007;40:1284–9.

    Article  CAS  PubMed  Google Scholar 

  49. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17:1726–33.

    Article  CAS  PubMed  Google Scholar 

  50. Watts NB, Bilezikian JP, Camacho PM, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of postmenopausal osteoporosis. Endocr Pract. 2010;16 Suppl 3:1–37.

    Article  PubMed  PubMed Central  Google Scholar 

  51. U.S. Preventive Services Task Force. Screening for osteoporosis: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2011;154:356–64.

    Google Scholar 

  52. Watts NB, Adler RA, Bilezikian JP, et al. Osteoporosis in men: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(6):1802–22.

    Article  CAS  PubMed  Google Scholar 

  53. Cosman F, de Beur SJ, LeBoff MS, et al. Clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int. 2014;25:2359–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Burge R, Dawson-Hughers B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007;22:465–75.

    Article  PubMed  Google Scholar 

  55. Office of the Surgeon General. Rockville (MD). Bone health and osteoporosis: a report of the surgeon general. Available on line at http://www.ncbi.nlm.nih.gov/books/NBK45502/#ch5.s8; 2004.

  56. Bouxsein ML, Genant HK, International Osteoporosis Foundation. The breaking spine. Available at http://www.iofbonehealth.org/sites/default/files/PDFs/WOD%20Reports/2010_the_breaking_spine_en.pdf. Accessed 16 Nov 2015.

  57. Goldstein CL, Chutkan NB, Choma TJ, Orr RD. Management of the elderly with vertebral compression fractures. Neurosurgery. 2015;77:533–45.

    Google Scholar 

  58. International Osteoporosis Foundation (IOF). Impact of osteoporosis. Available online at http://www.iofbonehealth.org/impact-osteoporosis. Accessed 23 Oct 2015.

  59. Darba J, Kaskens L, Perez-Alvarez N, Palacios S, Neyro JL, Rejas J. Disability-adjusted-life-years losses in postmenopausal women with osteoporosis: a burden of illness study. BMC Public Health. 2015;15:234–43.

    Article  Google Scholar 

  60. Stenderup K, Justesen J, Clausen C, Kassem M. Aging is associated with decreased maximal life span and accelerated senescence of bone marrow stromal cells. Bone. 2003;33:919–26.

    Article  PubMed  Google Scholar 

  61. Zhou S, Greenberger JS, Epperly MW, et al. Age-related intrinsic changes in human bone-marrow-derived mesenchymal stem cells and their differentiation to osteoblasts. Aging Cell. 2008;7:335–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. D’Amelio P, Roato I, D’Amico L, et al. Bone and bone marrow pro-osteoclastogenic cytokines are upregulated in osteoporosis fragility fractures. Osteoporos Int. 2011;22:2869–77.

    Article  PubMed  CAS  Google Scholar 

  63. Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C, on behalf of the IOF Working Group on Epidemiology and Quality of Life. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int. 2012;23:2239–56.

    Google Scholar 

  64. Kanis JA, Johansson H, Oden A, Dawson-Hughes B, Melton 3rd LJ, McCloskey EV. The effects of a FRAX revision for the USA. Osteoporos Int. 2010;21(1):35–40.

    Article  CAS  PubMed  Google Scholar 

  65. Donaldson MG, Cawton PM, Lui LY, et al. Estimates of the proportion of older white men who would be recommended for pharmacologic treatment by the new US National Osteoporosis Foundation guidelines. J Bone Miner Res. 2010;25:1506–11.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Watts NB. Osteoporosis in men. Endocr Pract. 2013;19:834–8.

    Article  PubMed  Google Scholar 

  67. Laurent M, Gielen E, Claessens F, Boonen S, Vanderschueren D. Osteoporosis in older men: recent advances in pathophysiology and treatment. Best Pract Res Clin Endocrinol Metab. 2013;27(4):527–39.

    Article  CAS  PubMed  Google Scholar 

  68. Sayer AA, Robinson SM, Patel HP, Shavlakadze T, Cooper C, Grounds MD. New horizons in the pathogenesis, diagnosis and management of sarcopenia. Age Ageing. 2013;42:145–50.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Di Monaco M, Castiglione C, Vallero F, Di Monaco R, Tappero R. Sarcopenia is more prevalent in men than in women after hip fracture: a cross-sectional study of 591 inpatients. Arch Gerontol Geriatr. 2012;55:e48–52.

    Article  PubMed  Google Scholar 

  70. Bijlsma AY, Meskers CG, Westendorp RG, Maier AB. Chronology of age-related disease definitions: osteoporosis and sarcopenia. Ageing Res Rev. 2012;11(2):320–4.

    Article  CAS  PubMed  Google Scholar 

  71. Gibson MJ, Andres RO, Isaacs B, Radebaugh T, Worm-Petersen J. The prevention of falls in later life. A report of the Kellogg International Work Group on the prevention of falls by the elderly. Dan Med Bull. 1987;34 Suppl 4:1–24.

    Google Scholar 

  72. Centers for Disease Control and Prevention. Important facts about falls. Available at http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html. Accessed 16 Nov 2016.

  73. Hayes WC, Myers ER, Morris JN, Gerhart TN, Yett HS, Lipsitz LA. Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcif Tissue Int. 1993;52:192–8.

    Article  CAS  PubMed  Google Scholar 

  74. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.

    Article  CAS  PubMed  Google Scholar 

  75. Klotzbuecher CM, Ross PD, Landsman PB, et al. Patients with prior fractures have an increased risk of future fractures: a summary of the literature and statistical synthesis. J Bone Miner Res. 2000;15:721–39.

    Article  CAS  PubMed  Google Scholar 

  76. Lonnroos E, Kautiainen H, Karppi P, et al. Incidence of second hip fractures. A population-based study. Osteoporos Int. 2007;18:1279–85.

    Article  CAS  PubMed  Google Scholar 

  77. Berry SD, Samelson EJ, Hannan MT, et al. Second hip fracture in older men and women: the Framingham Study. Arch Intern Med. 2007;167:1971–6.

    Article  PubMed  Google Scholar 

  78. Shen S-H, Huang K-C, Tsai Y-H, et al. Risk analysis for second hip fracture in patients after hip fracture surgery: a nationwide population-based study. J Am Med Dir Assoc. 2014;2015:725–31.

    Article  Google Scholar 

  79. Toussaint ND, Elder GJ, Kerr PG. Bisphosphonates in chronic kidney disease; balancing potential benefits and adverse effects on bone and soft tissue. Clin J Am Soc Nephrol. 2009;4(1):221–33.

    Article  CAS  PubMed  Google Scholar 

  80. Miller PD. The kidney and bisphosphonates. Bone. 2011;49(1):77–81.

    Article  CAS  PubMed  Google Scholar 

  81. Batchelor P. The changing epidemiology of oral diseases in the elderly, their growing importance for care and how they can be managed. Age Aging. 2015;44:1064–70.

    Article  Google Scholar 

  82. Spanou A, Lyritis GP, Chronopoulos E, Tournis S. Management of bisphosphonate-related osteonecrosis of the jaw: a literature review. Oral Dis. 2015;21(8):927–36.

    Article  CAS  PubMed  Google Scholar 

  83. Body JJ, Bergmann P, Boonen S, et al. Non-pharmacological management of osteoporosis: a consensus of the Belgian Bone Club. Osteoporos Int. 2011;22:2769–88.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Diab DL, Watts NB. Diagnosis and treatment of osteoporosis in older adults. Endocrinol Metab Clin N Am. 2013;42:305–17.

    Article  Google Scholar 

  85. Verbrugge FH, Gielen E, Milisen K, Boonen S. Who should receive calcium and vitamin D supplementation? Age Ageing. 2012;41:576–80.

    Article  PubMed  Google Scholar 

  86. Sipponen P, Maaross HI. Chronic gastritis. Scand J Gastroenterol. 2015;50(6):657–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Mayo Clinic. Healthy Lifestyle. Nutrition and healthy aging. Available at http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/calcium-supplements/art-20047097?pg=2. Accessed 31 Dec 2015.

  88. Black LJ, Anderson D, Clarke MW, Ponsonby A-L, Lucas RM, Ausimmune Investigator Group. Analytical bias in the measurement of serum 25-hydroxyvitamin D concentrations impairs assessment of vitamin D status in clinical and research settings. PLoS One. 2015;10:1–14.

    Google Scholar 

  89. Gallagher JC. Vitamin D, and aging. Endocrinol Metab Clin N Am. 2013;42:319–32.

    Article  Google Scholar 

  90. Armas LA, Hollis BW, Heaney RP. Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab. 2004;89(11):5387–91.

    Article  CAS  PubMed  Google Scholar 

  91. Bjelakovic G, Gluud LL. Nikolova, et al. Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev. 2014;10(1), CD007470.

    Google Scholar 

  92. Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–43.

    Article  PubMed  Google Scholar 

  93. Choi M, Hector M. Effectiveness of intervention programs in preventing falls: a systematic review of recent 10 years and meta-analysis. J Am Med Dir Assoc. 2012;13(2):188.e13–188.e21

    Google Scholar 

  94. Lee MS, Pittler MH, Shin BC, Ernst E. Tai Chi for osteoporosis: a systematic review. Osteoporos Int. 2008;19:139–46.

    Article  CAS  PubMed  Google Scholar 

  95. Go4Life from the National Institute on Aging at NIH. Available at https://go4life.nia.nih.gov/. Accessed 14 Dec 2015.

  96. National Council on Aging. Exercise programs that promote senior fitness. Available at https://www.ncoa.org/center-for-healthy-aging/physical-activity/physical-activity-programs-for-older-adults/. Accessed 14 Dec 2015.

  97. American Geriatrics Society and British Geriatrics Society. Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59:148–57.

    Article  Google Scholar 

  98. Centers for Disease Control and Prevention. STEADI stopping elderly accidents, deaths and injuries. Available at http://www.cdc.gov/steadi/. Accessed 14 Dec 2015.

  99. Gillispie LD, Robertson MC, Gillispie WJ, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;12(9), CD007146.

    Google Scholar 

  100. Liu S, Zhu Y, Chen W, Sun T, Cheng J, Zhang Y. Risk factors for the second contralateral hip fracture in elderly patients: a systematic review and meta-analysis. Clin Rehabil. 2015;29(3):285–94.

    Article  PubMed  Google Scholar 

  101. Marcocci C, Bollerslev J, Khan AA, Shoback DM. Medical management of primary hyperparathyroidism: proceedings of the fourth International Workshop on the Management of Asymptomatic Primary Hyperparathyroidism. J Clin Endocrinol Metab. 2014;99(10):3607–18.

    Article  CAS  PubMed  Google Scholar 

  102. Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 2014;24(12):1670–751.

    Article  PubMed  PubMed Central  Google Scholar 

  103. Cunningham JJ, Barzel US. Lean body mass is a predictor of the daily requirement for thyroid hormone in older men and women. J Am Geriatr Soc. 1984;32:204–7.

    Article  CAS  PubMed  Google Scholar 

  104. Kabadi UM. Variability of L-thyroxine replacement dose in elderly patients with primary hypothyroidism. J Fam Pract. 1987;24:473–7.

    CAS  PubMed  Google Scholar 

  105. Pecina J, Garrison GM, Bernard M. Levothyroxine dosage is associated with stability of TSH values. Am J Med. 2014;127:240–5.

    Article  CAS  PubMed  Google Scholar 

  106. Surks MI, Hollowell JG. Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. J Clin Endocrinol Metab. 2007;92:4575–82.

    Article  CAS  PubMed  Google Scholar 

  107. Gussekloo J, van Exel E, de Craen AJ, Meinders AE, Frolich M, Westendorp RG. Thyroid status, disability and cognitive function, and survival in old age. JAMA. 2004;292:2591–9.

    Article  CAS  PubMed  Google Scholar 

  108. Simonsick EM, Newman AB, Ferrucci L, et al. Subclinical hypothyroidism and functional mobility in older adults. Arch Intern Med. 2009;169:2011–7.

    Article  PubMed  PubMed Central  Google Scholar 

  109. Centanni M, Marignani M, Gargano L, et al. Atrophic body gastritis in patients with autoimmune thyroid disease: an underdiagnosed association. Arch Intern Med. 1999;159:1726–30.

    Article  CAS  PubMed  Google Scholar 

  110. Pearce SHS, Brabant G, Duntas LH, et al. 2013 ETA guideline: management of subclinical hypothyroidism. Eur Thyroid J. 2013;2:215–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  111. Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87:489–99.

    Article  CAS  PubMed  Google Scholar 

  112. Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA. 2004;29:228–38.

    Article  Google Scholar 

  113. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000;160:526–34.

    Article  CAS  PubMed  Google Scholar 

  114. Chaker L, Baumgartner C, Ikram MA, et al. Subclinical thyroid dysfunction and the risk of stroke: a systematic review and meta-analysis. Eur J Epidemiol. 2014;29:791–800.

    Article  CAS  PubMed  Google Scholar 

  115. Chaker L, Baumgartner C, den Elzen WPJ, et al. Subclinical hypothyroidism and the risk of stroke events and fatal stroke: an individual participant data analysis. J Clin Endocrinol Metab. 2015;100:2181–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  116. Chueire VB, Romaldini JH, Ward LS. Subclinical hypothyroidism increases the risk for depression in the elderly. Arch Gerontol Geriatr. 2007;44(1):21–8.

    Article  CAS  PubMed  Google Scholar 

  117. Blum MR, Bauer DC, Collet T-H, et al. Subclinical thyroid dysfunction and fracture risk. A meta-analysis. JAMA. 2015;313(20):2055–65.

    Article  PubMed  PubMed Central  Google Scholar 

  118. Akintola AA, Jansen SW, van Bodegom D, et al. Subclinical hypothyroidism and cognitive function in people over 60 years: a systematic review and meta-analysis. Front Aging Neurosci. 2015;7(150):1–10.

    CAS  Google Scholar 

  119. Abu-Helalah M, Law MR, Bestwick JP, Monson JP, Wald NJ. A randomized double-blind crossover trial to investigate the efficacy of screening for adult hypothyroidism. J Med Screen. 2010;17:164–9.

    Article  CAS  PubMed  Google Scholar 

  120. Hennessey JV, Espaillat R. Diagnosis and management of subclinical hypothyroidism in elderly adults: a review of the literature. J Am Geriatr Soc. 2015;63:1663–73.

    Article  PubMed  Google Scholar 

  121. Bahn RS, Burch HB, Cooper DS, et al. American Thyroid Association/American Association of Clinical Endocrinologists. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011;21(6):593–687.

    Article  CAS  Google Scholar 

  122. Laurberg P, Pedersen KM, Vestergaard H, Sigurdsson G. High incidence of multinodular toxic goitre in the elderly population in a low iodine intake area vs. high incidence of Graves’ disease in the young in a high iodine intake area: comparative surveys of thyrotoxicosis epidemiology in East-Jutland Denmark and Iceland. J Intern Med. 1991;229:415–20.

    Article  CAS  PubMed  Google Scholar 

  123. Ceccarelli C, Bencivelli W, Vitti P, Grasso L, Pinchera A. Outcome of radioiodine-131 therapy in hyperfunctioning thyroid nodules: a 20 years’ retrospective study. Clin Endocrinol (Oxf). 2005;62:331–5.

    Article  CAS  Google Scholar 

  124. Mitrou P, Raptis SA, Dmitriadis G. Thyroid disease in older people. Maturitas. 2011;70:5–9.

    Article  PubMed  Google Scholar 

  125. Wu W, Sun Z, Yu J, et al. A clinical retrospective analysis of factors associated with apathetic hyperthyroidism. Pathobiology. 2010;77:46–51.

    Article  CAS  PubMed  Google Scholar 

  126. Trivalle C, Doucet J, Chassagne P, et al. Differences in the signs and symptoms of hyperthyroidism in older and younger patients. J Am Geriatr Soc. 1996;46:50–3.

    Article  Google Scholar 

  127. Biondi B, Bartalena L, Cooper D, Hegedus L, Laurberg P, Kahaly G. The 2015 European Thyroid Association Guidelines on diagnosis and treatment of endogenous subclinical hyperthyroidism. Eur Thyroid J. 2015;4:149–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  128. Chaker L, Heeringa J, Dehghan A, et al. Normal thyroid function and the risk of atrial fibrillation: the Rotterdam study. J Clin Endocrinol Metab. 2015;100:3718–24.

    Article  CAS  PubMed  Google Scholar 

  129. Alexander EK, Bible KC, Doherty GM, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133.

    Article  PubMed  Google Scholar 

  130. Sawin CT, Geller A, Wolf PA, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med. 1994;331:1249–52.

    Article  CAS  PubMed  Google Scholar 

  131. Flynn RW, Bonellie SR, Jung RT, MacDonald TM, Morris AD, Leese GP. Serum thyroid-stimulating hormone concentration and morbidity from cardiovascular disease and fractures in patients on long-term thyroxine therapy. J Clin Endocrinol Metab. 2010;95:186–93.

    Article  CAS  PubMed  Google Scholar 

  132. Taillard V, Sardinoux M, Oudot C, et al. Early detection of isolated left ventricular diastolic dysfunction in highrisk differentiated thyroid carcinoma patients on TSH-suppressive therapy. Clin Endocrinol (Oxf). 2011;75:709–14.

    Article  CAS  Google Scholar 

  133. Petak SM, Nankin HR, Spark RF, Swerdloff RS, Rodriguez-Riqau LJ. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hypogonadism in adult male patients – 2002 update. Endocr Pract. 2002;8:440–59.

    PubMed  Google Scholar 

  134. Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2010;95:2536–59.

    Article  CAS  PubMed  Google Scholar 

  135. Wu FC, Tajar A, Beynon JM, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010;363:123–35.

    Article  CAS  PubMed  Google Scholar 

  136. Gielissen MF, Knoop H, Servaes P, et al. Differences in the experience of fatigue in patients and healthy controls: patients’ descriptions. Health Qual Life Outcomes. 2007;5:36–42.

    Article  PubMed  PubMed Central  Google Scholar 

  137. Park M, Reynolds III CF. Depression among older adults with diabetes. Clin Geriatr Med. 2015;31:117–37.

    Article  PubMed  Google Scholar 

  138. Ginsberg TB. Male sexuality. Clin Geriatr Med. 2010;26:185–95.

    Article  PubMed  Google Scholar 

  139. Travison TG, Araujo AB, Kupelian V, et al. The relative contributions of aging, health, and lifestyle factors to serum testosterone decline in men. J Clin Endocrinol Metab. 2007;92:549–55.

    Article  CAS  PubMed  Google Scholar 

  140. Mohr BA, Bhasin S, Link CL, O’Donnell AB, McKinlay JB. The effect of changes in adiposity on testosterone levels in older men: longitudinal results from the Massachusetts Male Aging Study. Eur J Endocrinol. 2006;155:443–52.

    Article  CAS  PubMed  Google Scholar 

  141. Wu FC, Tajar A, Pye SR, et al. Hypothalamic-pituitary-testicular axis dysruptions in older men are differentially linked to age and modifiable risk factors: the European male aging study. J Clin Endocrinol Metab. 2008;93:2737–45.

    Article  CAS  PubMed  Google Scholar 

  142. Dandona P, Dhindsa S. Hypogonadotropic hypogonadism in type 2 diabetes and obesity. J Clin Endocrinol Metab. 2011;96:2643–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  143. Jankowska EA, Biel B, Majda J, et al. Anabolic deficiency in men with chronic heart failure: prevalence and detrimental impact on survival. Circulation. 2006;114:1829–37.

    Article  CAS  PubMed  Google Scholar 

  144. Basaria S. Reproductive aging in men. Endocrinol Metab Clin N Am. 2013;42:255–70.

    Article  Google Scholar 

  145. Tajar A, Huhtaniemi IT, O’Neil TW, et al. Characteristics of androgen deficiency in late-onset hypogonadism: results from the European Male Aging Study (EMAS). J Clin Endocrinol Metab. 2012;97:1508–16.

    Article  CAS  PubMed  Google Scholar 

  146. Feldman HA, Loncope C, Derby CA, et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study. J Clin Endocrinol Metab. 2002;87:589–98.

    Article  CAS  PubMed  Google Scholar 

  147. Gan EH, Pattman S, Pearce S, Quinton R. Many men are receiving unnecessary testosterone prescriptions. BMJ. 2012;345, e5469.

    Article  PubMed  Google Scholar 

  148. Goodman N, Guay A, Dandona P, et al. American Association of Clinical Endocrinologists and American College of Endocrinology position statement on the association of testosterone and cardiovascular risk. Endocr Pract. 2015;21:1066–73.

    Article  PubMed  Google Scholar 

  149. Gencer B, Mach F. Testosterone: a hormone preventing cardiovascular disease or a therapy increasing cardiovascular events? Eur Heart J. 2015; pii: ehv439. [Epub ahead of print].

    Google Scholar 

  150. Matsumoto AM. Testosterone administration in older men. Endocrinol Metab Clin N Am. 2013;43:271–86.

    Article  CAS  Google Scholar 

  151. Bhattacharya RK, Bhattacharya SB. Late-onset hypogonadism and testosterone replacement in older men. Clin Geriatr Med. 2015;31:631–44.

    Article  PubMed  Google Scholar 

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Valencia, W.M., Florez, H. (2017). Endocrinology. In: Burton, J., Lee, A., Potter, J. (eds) Geriatrics for Specialists. Springer, Cham. https://doi.org/10.1007/978-3-319-31831-8_22

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