Clinical Section

Serum High-Density Lipoprotein Cholesterol Levels and Mortality in Frail, Community-Living Elderly
Francesco Landi^a, Andrea Russo^a, Marco Pahor^{b, c}, Ettore Capoluongo^a, Rosa Liperoti^a, Matteo Cesari^a, Roberto Bernabei^a, Graziano Onder<sup>a

a</sup>Department of Gerontology and Geriatrics, Catholic University of Sacred Heart, Rome, Italy;
^bDepartment of Aging and Geriatric Research, University of Florida College of Medicine, and
^cGeriatric Research, Education and Clinical Center (GRECC), Malcom Randall Veterans Affairs Medical Center, North Florida/South Georgia Veterans Health System, Gainesville, Fla., USA

Address of Corresponding Author

Gerontology 2008;54:71-78 (DOI: 10.1159/000111381)

  Key Words

• Frail community-living elderly
• High-density lipoprotein cholesterol
• Mortality, frail elderly

  Abstract

Background: High-density lipoprotein (HDL) cholesterol has been hypothesized to be a reliable marker of frailty and poor prognosis among the oldest elderly. Objective: In the present study, we evaluate the impact of HDL cholesterol on the risk of all-cause mortality in a large population of frail octogenarians and nonagenarians living in a community. Methods: We analyzed data from the Aging and Longevity Study in the Sirente geographic area (ilSIRENTE Study), a prospective cohort study that collected data on all subjects aged 80 year and older living in a mountain community (n = 359). The main outcome measure was the relative hazard ratio of death after 2 years of follow-up for different levels of HDL cholesterol. Results: A total of 86 deaths (30 men and 56 women) occurred during 2 years of follow-up. Among men the mean HDL cholesterol level was 36.7 ± 7.6 mg/dl among those who died as compared with 43.4 ± 10.3 mg/dl among survivors (p = 0.001). Similarly, among women, the mean HDL cholesterol level was 42.2 ± 11.5 mg/dl among those who died as compared with 49.3 ± 14.9 mg/dl among survivors (p = 0.001). Adjusting for potential confounders, including markers of frailty, LDL cholesterol, and triglycerides, somewhat reduced the strength of the association between HDL cholesterol levels and mortality, but it remained statistically significant. Conclusions: Our results obtained from a representative sample of very old and frail elderly subjects expand the knowledge that high levels of HDL cholesterol are associated with better survival. These findings support the hypothesis of a strong implication of the lipoprotein metabolism in the process of living an extremely long life.

Copyright © 2007 S. Karger AG, Basel

  Author Contacts

Francesco Landi, MD, PhD, Centro Medicina dell’Invecchiamento (CEMI)
Istituto di Medicina Interna e Geriatria
Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8
IT–00168 Roma (Italy)
Tel. +39 06 338 8546, Fax +39 06 305 1911, E-Mail francesco_landi@rm.unicatt.it

  Article Information

Received: August 21, 2007
Accepted: September 15, 2007
Published online: November 15, 2007
Number of Print Pages : 8
Number of Figures : 1, Number of Tables : 3, Number of References : 40