Cholesterol and Mortality in the Very Old

The effect of cholesterol as a risk factor in middle-aged individuals is clearly defined, as are the benefits of cholesterol-lowering therapies. Whether these same risks and benefits are pertinent to persons of age beyond 85 years (the "oldest old") is not well established.

Overall, the relationship between cholesterol and cardiovascular risk diminishes with age. The authors prospectively examined the relationship between cholesterol and cardiovascular risk in 724 persons older than 85 years in a Netherlands community followed for 10 years.

Each 1 mmol/L increase of total cholesterol was associated with a 15% decrease of overall mortality. In other words, increased cholesterol was associated with a decreased risk of death. Additionally, there was an inverse relationship between total cholesterol concentration and 10-year cancer survival. Though in this cohort of oldest old cardiovascular disease remained the most frequent cause of death, level of risk is not directly related to total cholesterol.

Weverling-Rijnsburger A, et al. Lancet 1997;350:1119-1123.