Thyroid disorders in old age

Thyroid disorders are more frequent in old age, especially in women. Overt thyroid dysfunction may manifest as aging itself or as age-associated disorders of other organs. Therefore, an accurate clinical suspicion is essential for their detection in elders with multiple comorbidities, malnutrition, and chronic polypharmacy. Because chronic diseases are more prevalent in old age, nonthyroidal illness is also common in this age group. Most thyroid nodules in older persons are benign, yet a comprehensive individualized evaluation is needed in order to timely detect malignancy. While there is still debate on the decision to treat or not to treat subclinical thyroid disorders, current recommendations indicate the necessity of considering treatment on an individual bases, balancing the possible benefit on quality of life versus the risks in the older person. Extended screening and treatment in the community population aged 65 years and over is discouraged, but screening on at-risk populations is recommended.