Low cholesterol, mortality, and quality of life in old age during a 39-year follow-up

Department of Oral Medicine, University of Helsinki, Helsinki, Uusimaa, Finland
Journal of the American College of Cardiology (Impact Factor: 16.5). 10/2004; 44(5):1002-8. DOI: 10.1016/j.jacc.2004.04.057
Source: PubMed


We assessed the impact of serum cholesterol level in early midlife on total mortality during up to 39 years of follow-up and on the quality of life (QoL) in old age.
Total effects of low serum cholesterol on health have been in dispute, especially in elderly persons, and there are few data on the long-term effects of low cholesterol on QoL.
The cohort consisted of 3,277 healthy businessmen age 30 to 45 years at baseline (1960s). In addition to baseline, serum cholesterol values were available for part of the cohort in 1974, 1986, and 2000. The QoL was assessed in 80.9% of survivors (n = 1,820, mean age 73 years) with a RAND-36 (SF-36) QoL questionnaire in 2000. Mortality up to 2002 (n = 1,173) was retrieved from national registers.
Cholesterol was clearly reduced in survivors during follow-up, except in the lowest baseline serum cholesterol group. Baseline cholesterol predicted 39-year total mortality in a graded manner (p < 0.0001), and a value < or =5.0 mmol/l was associated with a 25% reduction in total mortality. In old age, the physical component summary score of RAND-36 was significantly (p = 0.02) higher (better) in the lowest baseline cholesterol group; no difference was found in the mental component summary score (p = 0.51).
Low serum cholesterol level in midlife predicted not only better survival but also better physical function and QoL in old age, without adversely affecting mental QoL.

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    • "As same as the results of this study, Casiglia et al. (23) reported that the higher the TC levels, the lower mortality in the elderly. In addition, Strandberg et al. (24) suggested that low serum cholesterol level in midlife predicted not only better survival but also better physical function and quality of life (QOL) in old age. "
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    • "Thus, controlling for confounders, especially social class (Marmot et al., 2001), is important in observational studies. In the 2002–2003 survey of our long-term Helsinki Businessmen cohort (Strandberg et al., 2004), we also asked about candy preferences and consumption in the participants with an average age of 76 years. In the present cross-sectional analyses, we have related the use of chocolate vs other sugar confectionery to health and psychological well-being in old men. "
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    ABSTRACT: We hypothesized that chocolate preference would be related to health and psychological well-being in old men. We have followed up a socio-economically homogenous group of men, born in 1919-1934, since the 1960s. In 2002-2003, a mailed questionnaire was used to assess the health and well-being (including questions related to positive life orientation, visual analogue scales and the Zung depression score) of survivors. In addition, candy preference was inquired. Those men who reported no candy consumption (n=108) were excluded from the analyses. Psychological well-being in old age. The response rate was 69% (1367 of 1991). Of the respondents, 860 and 399 preferred chocolate and other type of candy, respectively. The average age in both candy groups was 76 years. Of the respondents, 99% were home-dwelling, 96% were retired and 87% were presently married, without differences between the candy groups. Men preferring chocolate had lower body mass index and waist circumference, and they also reported more exercise and better subjective health (P=0.008) than other candy consumers. Variables related to psychological well-being were consistently better in those preferring chocolate. The differences were statistically significant in feeling of loneliness (P=0.01), feeling of happiness (P=0.01), having plans for the future (P=0.0002) and the Zung depression score (P=0.02). In this socioeconomically homogenous male cohort, chocolate preference in old age was associated with better health, optimism and better psychological well-being. The Academy of Finland, the Päivikki and Sakari Sohlberg Foundation, the Helsinki University Central Hospital and the Finnish Foundation for Cardiovascular Research.
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