Cholesterol gallstones occur rarely in childhood and adolescence and increase linearly with age in both genders. To explore whether aging per se increases cholesterol saturation of bile and gallstone prevalence, and to investigate age-related changes in hepatic and biliary lipid metabolism, we studied gallstone-susceptible C57L mice and resistant AKR mice of both genders fed 8 weeks with a lithogenic diet containing 1% cholesterol, 0.5% cholic acid, and 15% butter fat starting at (young adult) 8, (older adult) 36, and (aged) 50-weeks-of-age. After the 8-week feeding, gallstone prevalence, gallbladder size, biliary lipid secretion rate, and HMG-CoA reductase activity were significantly greater but cholesterol 7 ␣ -hydroxylase activity was lower in C57L mice of both genders compared with AKR mice. Increasing age augmented biliary secretion and intestinal absorption of cholesterol, reduced hepatic synthesis and biliary secretion of bile salts, and decreased gallbladder contractility, all of which increased susceptibility to cholesterol cholelithiasis in C57L mice. We conclude that aging per se is an independent risk factor for cholesterol gallstone formation. Because aging increases significantly biliary cholesterol hypersecretion and gallstone prevalence in C57L mice carrying Lith genes, it is highly like that Longevity Cholesterol gallstone disease is influenced by a complex interaction of genetic and environmental factors (1) that determine the hypersecretion of biliary cholesterol into hepatic bile (2) and subsequently the precipitation of cholesterol crystals in gallbladder bile (3). Epidemiological and clinical investigations (4-8) have shown that cholesterol gallstones occur infrequently in childhood and adolescence, and the prevalence of cholesterol gallstone disease increases linearly with age in both genders and approaches 50% at age 70 in females. Furthermore, elderly individuals are at high risk for developing complications of gallstones and mortality from surgery is often unacceptably high in patients older than 65 (9-11). Although cholesterol saturation of bile is significantly higher in elderly Swedes (12) and Chilean women (13) and age correlates positively with increased hepatic cholesterol secretion rate (12), it has not been established how aging per se influences hepatic and biliary cholesterol metabolism. Furthermore, numerous studies on age-related hepatic cholesterol and bile salt metabolism (14-20), biliary cholesterol secretion and composition (12,13,21,22), gallbladder contraction function (23-26), and intestinal cholesterol absorption (27, 28) have been performed in humans and in different animal species; however, effects of aging on these parameters varied tremendously, being either normal, diminished, or elevated compared to young subjects. In particular, little is known whether aging per se influences cholesterol gallstone formation. In this study, using a unique genetically gallstone-susceptible C57L mouse model with Lith genes (2, 3, 29) compared to resistant AKR mice, we in...