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Total cholesterol and mortality in the elderly.

E Casiglia1, A Mazza, V Tikhonoff

  • 1Department of Clinical and Experimental Medicine, University of Padova, Italy. edoardo.casiglia@unipd.it

Journal of Internal Medicine
|September 17, 2003
PubMed
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High total cholesterol (TC) is a risk factor for coronary mortality in elderly men. However, low TC predicts noncardiovascular mortality in both genders and cancer mortality in women.

Area of Science:

  • Epidemiology
  • Gerontology
  • Cardiovascular Medicine

Background:

  • Total cholesterol (TC) is a key lipid parameter with established links to cardiovascular disease.
  • Understanding the association between TC levels and mortality risk across different genders and age groups is crucial for public health.
  • Previous studies have yielded conflicting results regarding the role of TC in mortality, particularly in elderly populations.

Purpose of the Study:

  • To investigate the association between total cholesterol levels and all-cause mortality in an elderly population.
  • To determine if TC is a significant risk factor for mortality in both men and women.
  • To explore gender-specific differences in the relationship between TC and mortality outcomes.

Main Methods:

  • A population-based, prospective study involving 3257 Italian adults aged 65-95 years.

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  • Total cholesterol was measured and analyzed as a continuous variable and by quintiles.
  • Multivariate relative risk (RR) of mortality was calculated for each TC quintile, adjusted for confounders, with stratification by gender, BMI, and smoking status.

    • Main Results:

    • High TC (fifth quintile vs. first) was a significant predictor of coronary mortality in men (RR: 2.40).
    • Low TC was associated with increased all-cause mortality in women.
    • Low TC also predicted miscellaneous mortality in both genders, a trend exacerbated by malnutrition or smoking.

    Conclusions:

    • Elevated total cholesterol remains a critical risk factor for coronary heart disease mortality in elderly men.
    • Very low cholesterol levels do not confer longevity in the elderly and are associated with increased noncardiovascular mortality, including neoplastic mortality in women.