Abstract
Changes in lipid metabolism with age result in lower total serum cholesterol and low-density lipoprotein concentrations. There is no evidence that longevity and lipid profiles are influenced by genetic make-up. It is difficult to establish an optimum total serum cholesterol in the elderly but values established in younger subjects give a guide. High-density lipoprotein may be even more protective in the elderly and could turn out to be a better predictor of coronary disease. Screening for the treatment of hypercholesterolemia should be carried out in the elderly. Although death is an inevitable fact, intervention in, for example, recently retired, apparently disease-free subjects is important. The first approach should be the introduction of changes in life style (increased exercise, stopping smoking, improved diet). Drugs may also be introduced if these interventions fail. Although drug therapy in the elderly may pose immediate problems due to poor renal and hepatic function, the adverse effects of long-term use have less relevance in the elderly.