Prognostic Significance of Serum Cholesterol in Nursing Home Men

Abstract

Serum cholesterol was measured in 129 men (average age 70.6; range 41-96) of a Veterans Administration Nursing Home, and was correlated with other items in an extensive clinical data base. Serum cholesterol was less than 150 mg/dl in 13% of the subjects, and was less than 160 mg/dl in 18%. Cholesterol greater than 280 mg/dl occurred in 8%. Serum cholesterol varied directly (p less than 0.02) with: body weight, serum albumin, serum total protein, serum sodium, ability to walk, and ability to feed oneself; and indirectly (p less than 0.02) with death rate, degree of functional dependence, and serum SGOT and LDH. Nursing home men with cholesterol less than 150 mg/dl had a death rate of 63% during the 14 months after the cholesterol analysis, compared to a death rate of 9% in men with cholesterol greater than 150 mg/dl (p less than 0.05). Death rate during the year after the analysis was 52% if cholesterol was below 160 mg/dl, compared to 7% if it was above this threshold (p less than 0.05).

Serum Cholesterol Levels as a Measure of Frailty in Elderly Patients

“…The independent association found in our study between malnutrition and cholesterol levels support the hypothesis made in a number of articles (Frisoni et al, 1994;Ranieri et al, 1995;Rudman et al, 1988;Sullivan & Walls, 1994;Verdery, 1992) that although not diagnostic by itself, hypocholesterolemia may be considered an indicator of malnutrition.…”

“…Serum cholesterol levels fall Experimental Aging Research, 24:169-179, 1998 Copyright © 1998 Taylor Francis 0361-073X/98 $12.00 + .00 in a multitude of illnesses, and low serum cholesterol has been associated with increased morbidity and mortality in the elderly; in fact, a J-or U-shaped relation between blood total cholesterol level and all-cause mortality has been reported in several studies. In particular, hypocholesterolemia has been found to be a predictor of death in nursing home patients (Rudman, Mattson, & Nagraj, 1988;Verdery & Goldberg, 1991), in hospital settings (Noel, Smith, & Ettinger, 1991), and in community residents (Harris et al, 1992;Ives, Bonino, Traven, & Kuller, 1993). Among hospitalized patients, hypocholesterolemia was associated not only with increased risk of mortality but also with increased rate of complications (especially infections), clear biochemical evidence of malnutrition, and higher duration and cost of hospitalization (Harris et al, 1992;Iribarren, Reed, Chen, Yano, & Dwyer, 1995;Ives et al, 1993;Wannamethee, Shaper, Whincup, & Walker, 1995).…”

Aging Liver

“…No doubt, this could contribute to the increased incidence of coronary artery disease in elderly subjects. In contrast, one study [18] of an aged institutionalized human population revealed that patients with serum levels of cholesterol !150 mg/dl exhibited a mortality rate of 63% when compared to 9% in patients with cholesterol levels 1150 mg/ dl. Another study from the same group [19] by multivariate analysis of a geriatric population, showed that men with serum cholesterol levels of ^156 mg/dl and hematocrit of ^41%, died at a rate 42 times to those of men with values above both thresholds.…”

Grenzen und Bedeutung der Labordiagnostik bei Mangelernährung im Alter

“…Eine etwas längerfristige Aussage in diesem Sinne wird immer wieder im Zusammenhang mit der Abnahme von Albumin und Cholesterin diskutiert [44]. Nach einer Studie die im Veteranen-Pflegeheim durchgeführt wurde, soll der plötzliche Cholesterin-Abfall ein zehnfach höhe-res Mortalitäts-Risiko anzeigen [45]. Auch der Anstieg von Kupfer im Serum sowie die Abnahme von Zink soll ebenfalls als ein negatives prognostisches Zeichen gewertet werden [46].…”