Declining cholesterol and mortality in a sample of older nursing home residents.
OBJECTIVE
To examine the association between declining serum cholesterol and mortality in a sample of older nursing home residents.


METHODS
A retrospective cohort study.


METHODS
A 203-bed nursing home.


METHODS
Persons aged 65 and older, resident in the nursing home on January 1, 1988, or admitted through December 31, 1989, were eligible (n = 185) for the study. Follow-up for mortality was conducted until June 30, 1991. Fifty-five survivors with two or more cholesterol levels recorded before January 1, 1990, and the 76 decedents with two or more recorded cholesterol levels constituted the analytic sample (71% of eligible subjects).


METHODS
Mortality of the nursing home residents.


RESULTS
Cholesterol declined 31.1 mg/dL/yr (95% confidence interval [CI], 19.7 to 42.6) among decedents, versus 4.2 mg/dL/yr (95% CI, -4.9 to 13.2) among survivors. The association between cholesterol decline (absolute or relative rates) and mortality was examined using logistic regression controlling for age, sex, and tube feeding. Compared with a referrent group with no change or increase, declining cholesterol greater than 45 mg/dL/yr was accompanied by an adjusted relative odds for death of 6.2 (95% CI, 2.1 to 18.4); declining cholesterol greater than 20% per year was accompanied by an adjusted relative odds for death of 7.3 (95% CI; 2.4 to 22.2). Extreme declines greater than 20% per year occurred in 47% of decedents but in only 15% of survivors.


CONCLUSIONS
Precipitously declining cholesterol appeared to be a marker for mortality in the sample and may help explain the low cholesterol-mortality association in older nursing home residents.
West Suburban Hospital Family Practice Residency, Oak Park, Illinois 60302, USA.
M D
MD
Grant
Z H
ZH
Piotrowski
T P
TP
Miles
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D004750:Enteral Nutrition; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D016017:Odds Ratio; D012044:Regression Analysis; D012189:Retrospective Studies; D016019:Survival Analysis; D015431:Weight Loss
D015415:Biomarkers; D002784:Cholesterol