Serum HDL and LDL cholesterol levels were not associated with survival to age 90 (LDL Q4 vs Q1 OR 1.07; 95% CI 0.88-1.31), but higher LDL predicted survival with intact mobility.
Cohort
Do higher serum levels of HDL and LDL cholesterol predict survival to age 90 in older postmenopausal women?
Higher LDL cholesterol levels in older postmenopausal women were associated with greater odds of surviving to age 90 with intact mobility, suggesting a need to reevaluate LDL targets in this population.
Effect estimate: OR 1.07 (95% CI 0.88-1.31)
OBJECTIVES: Although elevated lipid levels predict increased risk of coronary heart disease and death in middle-aged women and men, evidence is mixed if lipid levels measured in later life predict survival to very old ages. We examined lipid levels and survival to age 90 with or without intact mobility in a large cohort of older women. DESIGN: Prospective cohort. SETTING: Laboratory collection at a Women's Health Initiative (WHI) center and longitudinal follow-up via mail. PARTICIPANTS: Women aged 68 to 81 years at baseline. MEASUREMENTS: Serum high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol were collected at baseline. Participant survival status and self-reported mobility was compared across lipid levels. RESULTS: HDL and LDL levels were not associated with survival to age 90 after adjustment for cardiovascular risk factors (HDL: quartile (Q) 2: odds ratio OR = 1.14 95% confidence interval [CI = .94-1.38]; Q3 OR = 1.08 95% CI = .88-1.33; Q4 OR = 1.09 95% CI = .88-1.35; LDL: Q2 OR = 1.07 95% CI = .88-1.31; Q3 OR = 1.27 95% CI = 1.04-1.55; Q4 OR = 1.07 95% CI = .88-1.31). Similarly, no associations were observed between HDL and LDL levels and survival to age 90 with mobility disability. High HDL was not associated with survival to age 90 with intact mobility after adjustment for other cardiovascular risk factors. Compared with the lowest LDL quartile, the three upper LDL quartiles were associated with greater odds of survival to age 90 with intact mobility (LDL: Q2 OR = 1.31 95% CI = .99-1.74; Q3 OR = 1.43 95% CI = 1.07-1.92; Q4 OR = 1.35 95% CI = 1.01-1.80; P = .05). CONCLUSION: Neither higher HDL nor lower LDL levels predicted survival to age 90, but higher LDL predicted healthy survival. These findings suggest the need for reevaluation of healthy LDL levels in older women. J Am Geriatr Soc 68:288-296, 2020.
Maihofer et al. (Mon,) conducted a cohort in Postmenopausal women. Serum HDL and LDL cholesterol levels vs. Lowest quartile (Q1) was evaluated on Survival to age 90 (OR 1.07, 95% CI 0.88-1.31). Serum HDL and LDL cholesterol levels were not associated with survival to age 90 (LDL Q4 vs Q1 OR 1.07; 95% CI 0.88-1.31), but higher LDL predicted survival with intact mobility.