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Total Serum Cholesterol and Recovery From Disability Among Hospitalized Older Adults

¹ Department of Geriatrics, Catholic University of the Sacred Heart, Rome, Italy.
² Second Department of Clinical and Experimental Medicine, University of Ferrara, Italy.
³ Department of Aging and Geriatric Research, University of Florida, Gainesville.

Address correspondence to Graziano Onder, MD, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Policlinico A. Gemelli, L.go F. Vito 1, 00168 Rome, Italy. E-mail: graziano_onder{at}rm.unicatt.it

Background.The association between total serum cholesterol and health outcomes among older adults is controversial. The objective of the present study was to determine within a cohort of acutely hospitalized disabled elderly patients whether total cholesterol predicts recovery from disability in basic activities of daily living (ADL).

Methods.Patients (3150) 65 years old or older admitted to 81 acute care units in Italy and presenting with ADL disability at hospital admission were included in this study. ADL disability was defined as need of assistance or total dependence in one or more ADLs (eating, dressing, personal hygiene, transferring, and toilet use). Recovery was defined as no disability at hospital discharge in any of the five ADLs considered.

Results.Mean age of study participants was 80.5 ± 7.2 years, and 1305 (41.1%) were men. The rate of recovery from ADL disability was 14.5% for participants with total cholesterol <200 mg/dL (n = 306/2108), 20.2% for those with total cholesterol between 200 and 239 mg/dL (n = 144/713), and 23.1% for those with total cholesterol 240 mg/dL (n = 76/329). After adjustment for potential confounders, relative to that of patients with cholesterol <200 mg/dL, risk ratios for recovery were 1.31 for participants with cholesterol between 200 and 239 mg/dL (95% confidence interval [CI], 1.07–1.62) and 1.36 (95% CI, 1.04–1.79) for those with cholesterol 240 mg/dL. After exclusion of 769 patients with total cholesterol <145 mg/dL, the risk ratios (compared with those for participants with cholesterol <200 mg/dL) for recovery were 1.33 (95% CI, 1.07–1.66) for participants with cholesterol between 200 and 239 mg/dL and 1.41 (95% CI, 1.06–1.88) for patients with cholesterol 240 mg/dL.

Conclusions.Among hospitalized disabled older adults, elevated levels of cholesterol are associated with increased rate of recovery from ADL disability.