Aging heightens onset for thyroid disease. Thyroid disease may elevate risks factors for high cholesterol, heart disease, osteoporosis and reduced cognitive function. Thyroid disease may be difficult to detect or may be wrongly attributed to existing chronic disease. There are two types of diagnoses for the disease. When the thyroid produces too much hormone it’s called hyperthyroid. If too little hormone is made, it’s called hypothyroid. Hypothyroidism is much more common in the elderly population, and older women particularly are at risk with 1 in 5 women over the age of 65 having hypothyroidism.
Symptoms of hypothyroidism such as fatigue, lack of concentration, or dry skin can look like complaints associated with aging. Other symptoms can include arthritis, intolerance to cold or rapid temperature change, fluctuations in weight, or problems in the heart’s electrical system which can cause it to beat abnormally slow. Severe hypothyroidism may lead to congestive heart failure. Emotional and psychiatric well-being are major concerns for hypothyroidism. Depression, seizures, senile dementia, and slurred speech could be caused by hypothyroidism. In addition, low thyroid function is commonly associated with deteriorating cognition and Alzheimer’s disease. Changes in cognitive efficacy can be related to declines in working memory, language processing, problem-solving, long-term memory, and decision-making.
Patient education is an integral part of care. Chronic Care Management (CCM) can help patients, caregivers, and healthcare providers remain mindful of symptoms for hypothyroidism. For those patients diagnosed with the disease, CCM Care Managers can coordinate follow-up care with an endocrinologist, another specialist, or home care.
In addition to specific hypothyroidism treatment recommendations and care planning, Care Managers can monthly discuss related healthcare topics with patients. For example, many older adults are interested in nutrition, sexuality and aging, exercise, and other topics related to preventing illness and promoting quality of life. Seniors may be interested in tips for removing barriers to independence and learning how to maximize their strengths. CCM Care Managers are a strong resource for encouraging patient follow-up, building an awareness of community services to lessen social isolation, and adherence to medical recommendations.
With advancing age, there is often a corresponding normal decline in touch, hearing, vision, and memory function. The effects of chronic diseases, together with the normal changes that occur with aging, may hinder patient education. Care Managers are trained to identify challenges which hamper learning. They can provide patients with the right tools to address complex disease like hypothyroidism. Caregivers and healthcare providers must remember to check for an accurate diagnosis since hypothyroidism often looks a lot like another system in the body. Older patients with hypothyroidism require special attention to gradual and careful treatment, and most likely will require lifelong follow-up. Through careful assessment of developmental factors, selection of age-appropriate and tailored strategies is important to implement effective hypothyroidism patient and provider education.
Written by Joseph F. West, ScD on Tuesday, 24 January 2017. Posted in Low Thyroid Function, Hypothyroidism, Cognitive Health, CCM