Predictors of falling cholesterol levels in older adults: the Cardiovascular Health Study.
OBJECTIVE
To estimate 4-year change in serum total cholesterol levels in a population-based sample of older adults and identify independent predictors of cholesterol decline.


METHODS
Prospective study of 2837 adults aged 65 years and older with serum cholesterol measured in 1992-1993 and 1996-1997.


RESULTS
Mean serum cholesterol levels declined 6.3 mg/dl between the two examinations. Declines were greater in white (-7.3 mg/dl) than black (-1.4 mg/dl) participants and in those in good/excellent health (-0.9 mg/dl) vs. fair/poor health (-3.1 mg/dl; both p < 0.01). Factors associated with greater decline on multivariate analysis included age, male gender, and higher white cell count, albumin, and baseline cholesterol. Cholesterol levels declined 2.0 mg/dl per 6 year increment in baseline age and 6.8 mg/dl more in men than women after adjustment for other factors. C-reactive protein levels were unrelated to cholesterol change.


CONCLUSIONS
Declining cholesterol levels were associated with male gender, advanced age, weight loss, and white blood cell count but not with C-reactive protein levels. The role of declining cholesterol synthesis, due to as yet undefined age-related changes or to cytokine-mediated reductions related to illness, should be examined to help clarify the mechanisms of the sometimes marked declines in cholesterol levels observed at advanced ages.
Manolio
Teri A
TA
Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, MD 20892-7934, USA. manolio@nih.gov
Cushman
Mary
M
Gottdiener
John S
JS
Dobs
Adrian
A
Kuller
Lewis H
LH
Kronmal
Richard A
RA
D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D002784:Cholesterol / Q000009:adverse effects / Q000097:blood*; D005260:Female; D005544:Forecasting; D006304:Health Status; D006801:Humans; D008297:Male; D006278:Medicare; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
D002784:Cholesterol