Treatment of hypercholesterolemia in the elderly: The case for dietary intervention

Despite lack of direct evidence from controlled clinical trials, dietary treatment of hypercholesterolemia in elderly patients can be justified on several grounds: the high prevalence of this risk factor in the elderly, its association to coronary heart disease (CHD) mortality and morbidity at any age, and the ability of dietary intervention to reduce risks for CHD as well as other chronic diseases, and, therefore, to improve the overall health of this age group. Dietary treatment also can reduce or eliminate the need for drug treatment and its associated costs and side effects without a substantial change in food costs. The decision to recommend dietary treatment should be based on assessment of patients 'or caregivers' ability to comprehend the diet, access to food, and physical or economic impairments that might limit food shopping and preparation. On the basis of national data on dietary intake and the prevalence of hypercholesterolemias and nutritional deficiencies on older adults, and of the similarity between dietary changes proposed for treatment of hypercholesterolemia and those proposed for general health promotion, we recommend dietary intervention for patients of any age who are interested in and able to follow dietary prescriptions.