Age and Ageing, Vol 29, 69-74, Copyright © 2000 by British Geriatrics Society
PH Chyou and ED Eaker
OBJECTIVE: To study the impact of serum cholesterol concentrations on the
total risk of mortality in older people. DESIGN: Retrospective cohort study
with a follow-up of 8-10 years. SUBJECTS: A total of 989 subjects (367 men
and 622 women) aged 65 and over, living in the Marshfield Epidemiologic
Study Area at the time of their first complete serum lipid assessment.
METHODS: We calculated sex-specific mean levels of serum total cholesterol,
low-density lipoprotein, high-density lipoprotein and triglycerides, and
the ratio of total cholesterol to high-density lipoprotein, for subjects
who died of all causes and for those who survived to the end of follow-up,
with adjustment for relevant covariates. We obtained estimates of the risk
factor-adjusted sex-specific relative risk for all-cause mortality with
approximate quartiles of serum cholesterol concentrations by proportional
hazards regression models. We also evaluated the possible combined effects
of age, sex and cholesterol on all-cause mortality. RESULTS: A high level
of high-density lipoprotein was significantly associated with a low total
risk of mortality in older men. Conversely, an elevated ratio of total
cholesterol to high-density lipoprotein was directly related to an
increased total risk of mortality in older men. Age and high-density
lipoprotein level had a significant synergistic effect on all-cause
mortality for the elderly men. We found little or no association in women
between all-cause mortality and any of the lipid measures studied.
CONCLUSIONS: An increased ratio of total cholesterol to high- density
lipoprotein appears to be associated with an increase in risk for all-cause
mortality in men aged 65 and over, while an elevated level of high-density
lipoprotein, considered alone, seems to be protective against mortality
from all causes in men aged 65-74 years, but this effect diminishes over
the age of 75.
ARTICLES
Serum cholesterol concentrations and all-cause mortality in older people
Epidemiology Research Center, Marshfield Medical Research Foundation, WI 54449, USA. chyoup@mfldclin.edu
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