Cholesterol: What Older Adults Need to Know

By Thomas H.

As we age, managing cholesterol becomes an important part of staying healthy. You may already be working with your doctor to keep your cholesterol in check, know that there’s both “good” and “bad” cholesterol, and that too much cholesterol can lead to heart problems. But cholesterol and how to manage it changes over time. An approach to treatment that makes sense for someone in their 40s may not be appropriate for someone who is 60 or older. Here is a quick overview of what older adults need to know about cholesterol.

What is Cholesterol?

Cholesterol is a waxy substance found in your blood. Your body needs it to build healthy cells. It helps make hormones and vitamins that keep you healthy. Your liver makes most of the cholesterol in your body, but you also get some from foods like meat and dairy.

“Good” Cholesterol and “Bad” Cholesterol

The two main types of cholesterol are LDL and HDL. LDL is often called “bad” cholesterol because it can build up in your arteries and cause problems. HDL is known as “good” cholesterol because it helps remove other forms of cholesterol from your bloodstream. Many people have difficulty remembering which cholesterol is “good” and which is “bad.” It may you to remember that the “L” in LDL, the so-called “bad” cholesterol, can stand for “lethal” if you have too much of it.

How high cholesterol affects heart health

When you have too much cholesterol in your blood, it can stick to the walls of your arteries. This buildup is called plaque. Plaque makes your arteries narrow and stiff, and this can lead to heart attacks and strokes.

The role of genetics in cholesterol levels

Some people have high cholesterol because it runs in their family. This is called familial hypercholesterolemia. If your parents or grandparents had high cholesterol, you might be more likely to have it too.

The importance of regular cholesterol screenings:

Getting your cholesterol checked regularly is important, especially as you get older. According to the American Heart Association, most adults should have their cholesterol checked every 4 to 6 years, but your doctor may recommend more frequent testing based on your health status, age and other factors. If you have risk factors for heart disease, for example, you might need to be tested more often.

Normal cholesterol ranges and when to be concerned:

Doctors look at several different “numbers” when determining if someone has healthy cholesterol or not. These numbers indicate the amounts of each type of cholesterol that someone has in their blood, along with the total amount of cholesterol. In general, a healthy adult over the age of 20 should have a total cholesterol number of less than 200 mg/dL. HDL cholesterol should be between 40 and 60 mg/dL for men and between 50 and 60 mg/dL for women. Men and women alike should have less than 100mg/dl of LDL cholesterol. If your numbers are outside these ranges, your doctor will want to discuss ways for you to improve them.

Managing Your Cholesterol

Cholesterol numbers outside the normal range may require you to make some small changes to your daily routine and the foods you eat, or you may need to take medication. Drugs known as statins are the most common type of medicine used to treat high cholesterol. Sometimes, changing your diet and lifestyle alone can improve your cholesterol. The Mayo Clinic recommends the following for maintaining healthy cholesterol numbers:

eat heart-healthy foods

exercise/increase physical activity

stop smoking

lose weight

The Mayo Clinic adds that if you are already taking cholesterol-lowering medications, the changes listed above can boost their effectiveness. Read more about the Mayo clinic’s recommendations here: https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/reduce-cholesterol/art-20045935

Johns Hopkins Medicine points out that doctors must be cautious about prescribing statin drugs to older adults. Statins can interact with other medications that many older people take. Guidelines suggest that doctors should be extra careful with patients over 75. However, these guidelines are just a starting point. Sometimes, treating other health issues might be more important than managing cholesterol. When deciding on the best treatment approach, doctors will consider the patient’s overall health and preferences. [SOURCE: https://www.hopkinsmedicine.org/health/conditions-and-diseases/high-cholesterol/older-adults-and-high-cholesterol-what-you-need-to-know ]

New Developments

Our understanding of cholesterol and how it impacts our overall health continues to evolve. For example, recent research suggests that there may be a link between high cholesterol levels and cognitive health in older adults. It’s important to note, however, that the relationship between cholesterol and the brain is complex and more studies are needed. https://www.nbcnews.com/health/heart-health/good-hdl-cholesterol-dementia-risk-rcna118772.

If you are concerned about your cholesterol and how it may be impacting your health, make an appointment to see your doctor. This is especially important if it’s been a while since your last cholesterol screening. After you are screened, your doctor will discuss your cholesterol “numbers,” answer any questions you may have, and offer guidance on how to manage your cholesterol in a way that makes sense for your age and health status.