Please remember the possibility of reverse causality in observational studies
Dr. Saripanidis wonders whether statins would be harmful in older people. Frequently quoted reports of the epidemiological association of low cholesterol and mortality risk in old age keep causing confusion and false interpretations. The association is due to reverse causality (terminal decline lowers cholesterol, 1), and does by no means indicate, nor prove, that THERAPEUTIC reduction of cholesterol --by eg. statins -- would be harmful. In analogy, patients with hyperthyreosis or cancer have often both low cholesterol levels and increased mortality risk, but in those cases everyone realises that increased mortality is caused by the baseline condition – not lowered cholesterol !
1. Charlton J, Ravindrarajah R, Hamada S, Jackson SH, Gulliford MC. Trajectory of Total Cholesterol in the Last Years of Life Over Age 80 Years: Cohort Study of 99,758 Participants. J Gerontol A Biol Sci Med Sci. 2018;73:1083-1089. doi: 10.1093/gerona/glx184.
Competing interests: As earlier reported. I still keep taking a statin despite being >60 years.