Association of Thyroid dysfunction with cognitive function an individual participant data analysis

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.Molecular Epidemiolog

Forage legumes from the Mediterranean Fynbos biome of South Africa with potential for domestication: slope aspect affects tissue fibre and mineral composition

Fabaceae plants contribute greatly to a high quality of pasture in rangelands, because of high levels of protein in their tissues. Despite this established importance, only a few southern African legumes have been evaluated for nutritional value and domestication. The Overberg renosterveld vegetation of the Fynbos biome occupies undulating landscapes that have multiple slope aspects, creating variable microclimatic conditions affecting nutrient dynamics, species richness and plant chemical compositions. We assessed the effect of slope aspect on fiber and mineral composition of forage species present to provide information on the importance of slope for species characterization and nutritional value for domestication. Tissue samples from six replicates of the same species occurring on opposing aspects were collected for nutritional assessment. Results on the data showed that fibre and mineral composition differed in species occurring on different slopes, albeit with few exceptions. The concentrations of P, K and Mg in some species were significantly higher on the cooler and wetter south facing slopes relative to north facing slopes. Nutrient elements in soil samples collected from each site varied with slope aspects and elements. It is recommended that topography should be considered when studying forage nutritional assessments as part of future domestication programs

Native legume species as potential fodder crops in the mediterranean renosterveld shrubland, South Africa

The limited grazeable size of renosterveld vegetation in the Western Cape warranted assessment of chemical and fibre composition of the species to determine their nutritive value. We hypothesised that Fabaceae has chemically superior palatable species relative to Poaceae, Asteraceae and Asparagaceae species in the area. Plant samples were collected in the Overberg region from 11 sites. The species sampled from these four families Fabaceae, Poaceae, Asteraceae, and Asparagaceae were analysed for macro- and micro-elements, fibre and secondary compounds. At each site, replicated soil samples were also collected and analysed for pH, macro- and micro-elements. Fabaceae recorded the greatest concentration of crude protein, but the Poaceae was the most fibrous relative to Fabaceae and Asteraceae. All the species contained adequate levels of nutrients except P, Zn and sometimes Cu. Soil concentration of macronutrients and carbon in the soil varied with location. Based on crude protein, neutral detergent fibre and digestibility, the three most important parameters defining forage quality, the Fabaceae species Aspalathus hispida, A. angustifolia, A. nigra and A. submissa were regarded as superior forage species in the Mediterranean renosterveld. Livestock relying on only the renosterveld species in the Western Cape as forages should receive P and Zn supplements

REFLECTING ON NINETY YEARS OF INTERMITTENT SUCCESS: THE EXPERIENCE OF THE SOUTH AFRICAN RESERVE BANK WITH INFLATION SINCE 1921

The South African Reserve Bank (the Bank) has achieved intermittent excellence in its quest to contain inflation since its establishment in 1921. This long experience highlights important experiences with inflation, which can be put to good use by central banks in other emerging-market economies. The conclusion is that there is no substitute for the long-run use of sound monetary policy in the quest to contain inflation.http://www.journals.co.za/ej/ejour_sajeh.htm

How Influential is Economics?

economic policy, economics, economists, influence, politics, A11, A12, A13, B40, F20, J20,