New wisdom about high cholesterol treatment for adults aged 80 and older

Experts know that in adults younger than 65, having high cholesterol levels in your blood can raise your risk for heart attacks and strokes. However, in adults 80 years old and older, researchers have not–until now–thoroughly studied high cholesterol’s impact on heart disease, your ability to function well, or your risk for death.

In fact, some research shows that a higher level of total cholesterol and a lower level of so-called “bad” cholesterol (also known as “low-density lipoprotein” or LDL cholesterol) might be helpful in protecting your ability to perform daily activities and preserving your life for longer.

What’s more, it appears that having low cholesterol is linked to a higher risk of death from cancer, respiratory disease, and accidents in adults aged 80 and older. It also appears that the benefits of taking medications known as statins, which lower cholesterol, may lessen as people age. Researchers even have a phrase for this phenomenon. They call it the “risk factor paradox.” This describes the fact that for adults aged 80 and older, having some conditions that are considered health risks in younger adults predicts better survival. These conditions include having higher total cholesterol, higher blood pressure, and higher body mass index (BMI, a ratio of body weight to height that helps determine whether you are overweight or obese).

“Triglycerides” are one type of blood fat that your body uses for energy. High levels of triglycerides can raise risks for heart disease in younger adults. However, we don’t know as much about the risks to adults aged 80 and older, or whether high levels of triglycerides can affect their risks for disability or even death.

A team of researchers in China decided to learn more about whether current triglyceride-level guidelines make sense for people aged 80 and older. To do so, the team explored links between triglyceride levels and the ability to perform daily self-care activities, cognitive function (the ability to think and make decisions), and frailty (a condition associated with aging that increases the risks of poor health, falls, disability, and death. Signs of frailty include weakness, weight loss, and low activity levels.). Researchers also looked at whether triglyceride levels had an impact on death in a group of 930 Chinese adults aged 80 or older.

The researchers learned that for the oldest people in the study, having a higher triglyceride level was linked to a lower risk of cognitive decline, less of a reduction in the ability to perform daily tasks, less frailty, and lower risk for death.

The researchers said their results challenge current thinking that having high triglyceride levels is a risk factor for age-related chronic disorders and death. The researchers said their study suggested that, after the age of 80, taking medication to lower cholesterol may not have much–or any–benefit.

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This summary is from “Triglycerides paradox among the oldest old: ‘The lower the better?’)” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Yue-Bin Lv, MD; Chen Mao, MD, PhD; Xiang Gao, MD, PhD; Zhao-Xue Yin, MD; Virginia Byers Kraus, MD, PhD; Jin-Qiu Yuan, MD, PhD; Juan Zhang, MD, PhD; Jie-Si Luo, MD; Yi Zeng, PhD; and Xiao-Ming Shi, MD, PhD.

This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation’s work, visit http://www.HealthinAgingFoundation.org.

Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has–for 75 years–worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.