Serum total cholesterol: A mortality predictor in elderly hospitalized patients

Background & aims: Elevated serum total cholesterol levels are associated with increased risk of cardiovascular mortality among middle aged adults, but not the elderly. We therefore examined whether increased serum total cholesterol reduces mortality risk in the hospitalized elderly. Methods: Of 1852 patients consecutively admitted to an acute geriatric department from 1/1/99-12/31/00, only 298 (49.6% males, mean age 81.36 +/- 6.3 years) who had measured serum total cholesterol and albumin levels were included in the study and followed until August 31, 2004. Mortality data were extracted from their death certificates. Results: During follow-up of 3.47 +/- 1.87 years, 248 patients died. These patients had significantly lower levels of baseline serum total cholesterol (183.3 +/- 45.4 vs. 200.2 +/- 37.9, p = 0.01) and albumin (3.6 +/- 0.5 vs. 3.8 +/- 0.3 g/l, p = 0.002) than the survivors. In the Cox regression analysis, serum total cholesterol emerged as a significant, independent predictor of mortality in this cohort. Specifically, each 1 mg/dl increase in serum total cholesterol reduced risk of death by 0.4%. This association persisted even after controlling for serum creatinine, age, body mass index, dementia and congestive heart failure. These factors were also significantly, independently associated with mortality. Conclusion: In very elderly hospitalized subjects, increased levels of serum total cholesterol and albumin may be associated with reduced mortality risk. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.