Optimal serum total cholesterol level for life expectancy and for active-life expectancy in the Japanese elderly

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The association of serum total cholesterol concentration (TC) with all-cause mortality and with decline in functional capacity was investigated in the Japanese elderly. In 454 men and 632 women aged 65 years and over at baseline who were ambulatory, TC was measured Mortality risk during 6 years of follow-up was calculated using a proportional hazards model, adjusted for region, age, serum albumin, sistolic blood pressure, body mass index, and smoking. Of 1086 subjects, 23 who took a medicine for hyperlipidemia, and 13 who died within a year were excluded from the analysis. During the 6-year follow-up, 22.4% of men and 12.1% of warren died. TC for the young-old (66-74 years) elderly had a U-shaped relationship with mortality in both sexes. For the young-old, low TC (lowest quartile, <4.0 mmol/L for men (relative hazard (RH)=3.3), <4.7 mmol/L for women (RH=2.3)) was significant mortality risk, and high TC (highest quartile, >5.4 mmol/L for men (RH=3.3)) was also significant mortality risk for men. Lowest relative hazard in the young-old was at TC between 4.0 and 4.7 mmol/L for women, and between 4.7 and 5.3 mmol/L for women. While for the old-old (75 years and over) elderly, TC was not associated with mortality for men, furthermore, among women, a significant inverse association was found. Lowest relative hazard in the old-old women was at TC 6.0 mmol/L and over (highest quartile). The optimal TC for the old-old elderly appears to be different from that for the young-old elderly. TC was not associated with decline in functional capacity.