Declining Cholesterol and Mortality in a Sample of Older Nursing Home Residents

Grant, Mark D; Piotrowski, Z; Miles, Toni P.

doi:10.1111/j.1532-5415.1996.tb05634.x

Cited by 25 publications

(18 citation statements)

References 24 publications

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“…It remains to be explained the difference between our results and those of Hu et al In high‐functioning elderly subjects, such as those studied by Hu et al, hypocholesterolemia is related to specific diseases whose direct effect on mortality is elevated. On the contrary, when detected in disabled patients (such as ours) hypocholesterolemia is the final pathway of nonspecific, chronic, long‐lasting events, thus becoming an independent marker of frailty whose effect on mortality is higher than that of disease related conditions 6,7 …”

Section: Association Between 12‐month Mortality and Serum Cholesteromentioning

confidence: 83%

Cholesterol and Mortality in Elderly Patients

Rozzini

Sabatini

Franzoni

et al. 2004

J American Geriatrics Society

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Section: Association Between 12‐month Mortality and Serum Cholesteromentioning

confidence: 83%

Cholesterol and Mortality in Elderly Patients

Rozzini

Sabatini

Franzoni

et al. 2004

J American Geriatrics Society

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“…15 Alb and T.Chol levels are currently used as nutritional prognostic indices in the elderly, and when their levels are low, one may expect high death rates from diseases. [16][17][18] A low Alb concentration has been observed, to be a risk factor for myocardial infarction or cardiac adverse events with advanced atherosclerosis. 19,20 The higher Alb level for DIC-A as compared with DIC-D in this study was due to extrinsic Alb infusion.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of disseminated intravascular coagulation in septic systemic inflammatory response syndrome in nursing home residents

Kikuchi

Inagaki

Miyagawa

et al. 2006

Geriatrics Gerontology Int

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Aims: Disseminated intravascular coagulation syndrome (DIC) is a serious complication in elderly patients with systemic inflammatory response syndrome (SIRS). We investigated whether the clinically relevant parameters of atherosclerosis, nutrition and cellular immunity are determining factors for DIC in septic SIRS patients or not. Patients and methods:Forty-four subjects aged 65 years or over were enrolled, all of whom had bacterial sepsis and a high concentration of C-reactive protein (≥ 15.0 mg/dL). Subjects were given gabexate mesilate (GM) following diagnosis of DIC. They were divided into the following groups: N-DIC, subjects with SIRS but not DIC (n = 22); DIC-A, subjects with SIRS and DIC who survived through treatment with GM (n = 6); and DIC-D, subjects who had SIRS and DIC and died despite treatment with GM (n = 16).Results: Subjects with a low hemoglobin or serum albumin concentration, and atrial fibrillation at admission had a significantly high incidence of DIC, which was not high in subjects with myocardial ischemia, past history of overt cerebral infarctions or periventricular lucency. There was no difference in hemoglobin concentration between DIC-A and DIC-D. Differences in increases in CD11b-and CD14-positive mononuclear cells between DIC and N-DIC subjects were not significant. Post-mortem examinations showed that the ratio of the width of the thoracic aorta to that of the abdominal aorta was significantly higher for DIC-D than DIC-A. Conclusion:Nutritional disorders and irregularity in aortic blood flow are significant risks of DIC. Treatment with GM alone is not sufficient to achieve survival in patients with DIC and SIRS.

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“…In a multivariate analysis, the most predictive factors were cholesterol and hematocrit [34]. The decrease of cholesterol level was also found as a potent marker of mortality in an 18-month follow-up study, including 370 nursing home residents [35]. In total, 76 subjects (21%) died during follow-up; in these individuals average cholesterol level declined by 31.1 (range 19.7 to 4 2 .…”

Section: Changes In Cholesterol Levels With Agementioning

confidence: 97%

“…9 t o 13.2) mg/dL annually among survivors. However, there is good evidence that low cholesterol is merely a marker rather than the cause of mortality, since there is no association between genetically low cholesterol and morbi-mortality [35].…”

Section: Changes In Cholesterol Levels With Agementioning

confidence: 99%

Prevention of cardiovascular events in elderly hypercholesterolemic patients

Bruckert

1999

Curr Atheroscler Rep

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The management of hyperlipidemia in the elderly patient is a major problem, given the frequency of dyslipidemias and cardiovascular disorders in this age group. Therapy must take current uncertainties into account and, in the absence of therapeutic studies carried out in the elderly, is typically based upon a case-by-case approach. Raised cholesterol levels remain a significant risk factor for coronary heart disease (CHD) in the elderly. Although the relative risk of CHD tends to diminish with increasing age, this reduction is accompanied by an increase in absolute risk (ie, the number of events) as the frequency of the illness increases markedly with age. The results of major outcome studies with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins), when analyzed according to patient age, indicate that the benefits of these agents are not merely confined to younger individuals. However, the elderly form a unique patient population--the proportion of women is greater and the profile of cardiovascular illnesses is characterized, among others, by a greater incidence of cerebrovascular accidents. Problems relating to poor tolerability and comorbidity (which may give rise to drug-drug interactions) also occur more frequently in this age group. Moreover, the potential widespread treatment of hyperlipidemia in the elderly has profound economic implications. Under these circumstances, the clinical practice recommendations depend upon a reasonable extrapolation of epidemiologic and therapeutic data obtained from middle-aged men. At present, treatment is therefore aimed at patients with the most severe forms of hyperlipidemia, generally in the secondary prevention setting, taking into account the patient's life expectancy. The results of ongoing studies will determine the benefits of lipid-lowering therapy for primary prevention of CHD in the elderly.

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Declining Cholesterol and Mortality in a Sample of Older Nursing Home Residents

Abstract: Precipitously declining cholesterol appeared to be a marker for mortality in the sample and may help explain the low cholesterol-mortality association in older nursing home residents.

Cited by 25 publications

References 24 publications

Cholesterol and Mortality in Elderly Patients

Cholesterol and Mortality in Elderly Patients

Risk factors of disseminated intravascular coagulation in septic systemic inflammatory response syndrome in nursing home residents

Prevention of cardiovascular events in elderly hypercholesterolemic patients

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