Relation of plasma lipids to all-cause mortality in Caucasian, African-American and Hispanic elders

Objectives: to investigate the relation of plasma lipids to all-cause mortality in a multi-ethnic cohort of non-demented elderly. Setting: community-based sample of Medicare recipients, 65 years and older, residing in Northern Manhattan. Participants: about two thousand five hundred and fifty-six non-demented elderly, 65103 years. Among participants, 66.1% were women, 27.6% were White/non-Hispanic, 31.2% were African-American and 41.2% were Hispanic. Methods: a standardised assessment, including functional ability, medical history, physical and neurological examination and a neuropsychological battery was conducted. Vital status was ascertained through the National Death Index (NDI). We used survival analyses stratified by race and ethnicity to examine the relation of plasma lipids to subsequent all-cause mortality. Results: hispanics had the best overall survival, followed by African-Americans and Whites. Whites and African-Americans in the lowest quartiles of total cholesterol, non-HDL cholesterol and low-density lipoprotein cholesterol (LDL cholesterol) were approximately twice as likely to die as those in the highest quartile (White HR: 2.2, for lowest total cholesterol quartile; HR: 2.3, for lowest non-HDL cholesterol quartile; and HR: 1.8, for lowest LDL cholesterol quartile. African-American HR: 1.9, for lowest total cholesterol, HR: 2.0, for lowest non-HDL cholesterol and HR: 1.9, for lowest LDL cholesterol). In contrast, plasma lipid levels were not related to mortality risk among Hispanics. Conclusions: hispanic ethnicity modifies the associations between lipid levels and all-cause mortality in the elderly.