Increases in serum non-high-density lipoprotein cholesterol may be beneficial in some high-functioning older adults: MacArthur studies of successful aging.
objectives: To examine the association between changes in serum non-high-density lipoprotein cholesterol (non-HDL-C) over a 2.5-year period and risk of adverse health outcomes in the following 4.5 years in high-functioning older adults.


METHODS
Prospective cohort, established in 1988, with a follow-up in 1991 and 1995.


METHODS
Population-based, community-dwelling men and women.


METHODS
A random sample (n=267) from the MacArthur cohort (N=1,189). The cohort represented the highest-functioning tertile of 4,030 screened candidates aged 70 to 79.


METHODS
Change in non-HDL-C between 1988 and 1991 was measured as a predictor of health outcomes between 1991 and 1995, including all-cause mortality, and among survivors, incident heart attack or stroke, development of new disability in basic activities of daily living, and decline in performance on the Short Portable Mental Status Questionnaire.


RESULTS
More-positive change in non-HDL-C between 1988 and 1991 was associated with fewer adverse outcomes between 1991 and 1995. In individuals whose total cholesterol at baseline was in the middle two quartiles (195-244 mg/dL), each 10-mg/dL increase in the 1988-to-1991 change in non-HDL-C was associated with an adjusted mortality odds ratio (OR) of 0.67 (95% confidence interval (CI)=0.51-0.88). In individuals without cardiovascular disease at baseline, the adjusted OR for new physical disability was 0.79 (95% CI=0.65-0.95) and for cognitive decline was 0.81 (95% CI=0.67-0.98).


CONCLUSIONS
Increases in cholesterol over time have beneficial associations in some older adults. The role of cholesterol changes in the health of older individuals needs further exploration.
Karlamangla
Arun S
AS
Division of Geriatrics, Department of Medicine, School of Medicine, University of California at Los Angeles, Los Angeles, California 90095, USA. akarlamagla@mednet.ucla.edu
Singer
Burton H
BH
Reuben
David B
DB
Seeman
Teresa E
TE
D000203:Activities of Daily Living; D000368:Aged; D001900:Boston / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D002784:Cholesterol