Thyroid disease can be difficult to diagnose in the elderly; symptoms may develop insidiously and present a typically.1 Both hypo- and hyperthyroidism can present with depression and apathy, which are common in old age itself. Both can cause cardiovascular and psychiatric disease.2 Close to 1% of elderly people in the general population are hypothyroid on biochemical testing; about 0.5% are hyperthyroid.3 The prevalences in hospitalised patients are double.2
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