The inverse association between age and cholesterol level among older patients: The role of poor health status

Background: The total cholesterol concentration decreases with age in older people. The reasons for this phenomenon are controversial. This study inve stigated the hypothesis that poor health status is a determinant of the inv erse association between age and cholesterol in older persons. Methods: Cro ss-sectional study of 2,486 (53% women) older medical patients (greater tha n or equal to 65 years) admitted at 35 centers of the Gruppo Italiano di Fa rmacovigilanza nell'Anziano (GIFA) study in Italy. Total cholesterol was me asured on the fi rst day after admission to the hospital. Disease burden an d comorbidity were assessed by the Charlson index; low serum albumin and ir on were considered markers of frailty and poor health. Results: In men ther e was a significant, inverse age-cholesterol relationship (-0.97 mg/dl per year, p < 0.001). In women the association was nonlinear and cholesterol si gnificantly decreased after the age of 75 (-0.95 mg/dl per year, p < 0.005) . In multiple linear regression analysis, indicators of poor health account ed for almost two thirds of the crude effect of age on the cholesterol leve l in both men and women (adjusted coefficients for age were: for men, -0.38 mg/dl per year, p = 0.044; for women after the age of 75, -0.37 mg/dl per year, p = 0.205). The unadjusted probability of having low cholesterol sign ificantly increased with age among men (p for trend <0.005). In multiple lo gistic regression, indicators of poor health were strongly associated with low cholesterol in both men and women. After adjusting for indicators of po or health, the association between age and low cholesterol in men was no lo nger present. Conclusion: These findings suggest that the age-dependent red uction of cholesterol often observed in clinical and epidemiologic studies is substantially explained by the effect of poor health status. Low cholest erol in older persons may be a marker of poor health. Copyright <(c)> 2001 S. Karger AG,Basel.