title: Serum total cholesterol levels and all-cause mortality in a home-dwelling elderly population: a six-year follow-up.
abstract: OBJECTIVE
  To investigate the association between serum total cholesterol and all-cause mortality in elderly individuals aged > or = 75 years. Design. A prospective cohort study with a six-year follow-up.
  
  
  METHODS
  A random sample (n = 700) of all persons aged > or = 75 years living in Kuopio, Finland. After exclusion of participants living in institutional care and participants using lipid-modifying agents or missing data on blood pressure and cholesterol levels, the final study population consisted of 490 home-dwelling elderly persons with clinical examination. We used the Cox proportional hazard model and the propensity score (PS) method. Main outcome measure. All-cause mortality. Results. In an age- and sex-adjusted analysis, participants with S-TC > or = 6mmol/l had the lowest risk of death (hazard ratio, HR = 0.48, 95% CI 0.33-0.70) compared with those with S-TC < 5 mmol/l. HR of death for a 1 mmol increase in S-TC was 0.78. In multivariate analyses, the HR of death for a 1 mmol increase in S-TC was 0.82 and using S-TC < 5 mmol/l as a reference, the HR of death for S-TC > or = 6 mmol/l was 0.59 (95% CI 0.39-0.89) and for S-TC 5.0-5.9 mmol/l, the HR was 0.62 (95% CI 0.42-0.93). In a PS-adjusted model using S-TC < 5 mmol/l as a reference, the HR of death for S-TC > or = 6 mmol/l was 0.42 (95% CI 0.28-0.62) and for S-TC 5.0-5.9 mmol/l, the HR was 0.57 (95% CI 0.38-0.84). Conclusions. Participants with low serum total cholesterol seem to have a lower survival rate than participants with an elevated cholesterol level, irrespective of concomitant diseases or health status.
authors.affiliation: Department of Social Pharmacy, University of Kuopio and Kuopio Research Centre of Geriatric Care, Kuopio, Finland. Paivi.Tuikkala@uku.fi
authors.forename: Päivi
authors.initials: P
authors.lastname: Tuikkala
authors.forename: Sirpa
authors.initials: S
authors.lastname: Hartikainen
authors.forename: Maarit J
authors.initials: MJ
authors.lastname: Korhonen
authors.forename: Piia
authors.initials: P
authors.lastname: Lavikainen
authors.forename: Raimo
authors.initials: R
authors.lastname: Kettunen
authors.forename: Raimo
authors.initials: R
authors.lastname: Sulkava
authors.forename: Hannes
authors.initials: H
authors.lastname: Enlund
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009026:Mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies
chemical_list: D002784:Cholesterol
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