Association between serum cholesterol and noncardiovascular mortality in older age

J Am Geriatr Soc. 2011 Oct;59(10):1779-85. doi: 10.1111/j.1532-5415.2011.03593.x. Epub 2011 Sep 21.


Objectives: To clarify the association between cholesterol and noncardiovascular mortality and to evaluate how this association varies across age groups.

Design: Prospective population-based cohort study.

Setting: Rotterdam, the Netherlands.

Participants: Adults aged 55 to 99 (N = 5,750).

Measurements: Participants were evaluated for total cholesterol and subfractions and followed for mortality for a median of 13.9 years. Total cholesterol and its subfractions were evaluated in relation to noncardiovascular mortality. Cox regression analyses were conducted in the total sample and within age-groups (55-64, 65-74, 75-84, ≥85).

Results: Age- and sex-adjusted analyses showed that each 1-mmol/L increase in total cholesterol was associated with an approximately 12% lower risk of noncardiovascular mortality (hazard ratio (HR) = 0.88, 95% confidence interval (CI) = 0.84-0.92, P < .001). Age group-specific analyses demonstrated that this association reached significance after the age of 65 and increased in magnitude across each subsequent decade. This was driven largely by non-high-density lipoprotein cholesterol (non-HDL-C) (HR = 0.89, 95% CI 0.85-0.93, P < .001) and was partly attributable to cancer mortality. Conversely, HDL-C was not significantly associated with noncardiovascular mortality (HR = 0.92, 95% CI 0.79-1.07, P = .26).

Conclusion: Higher total cholesterol was associated with a lower risk of noncardiovascular mortality in older adults. This association varied across the late-life span and was stronger in older age groups. Further research is required to examine the mechanisms underlying this association.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / mortality*
  • Cause of Death*
  • Cholesterol / blood*
  • Cholesterol, HDL / blood*
  • Female
  • Health Surveys
  • Humans
  • Hypercholesterolemia / blood*
  • Hypercholesterolemia / mortality*
  • Male
  • Middle Aged
  • Neoplasms / mortality
  • Netherlands
  • Proportional Hazards Models
  • Registries
  • Survival Analysis


  • Cholesterol, HDL
  • Cholesterol