Cholesterol screening in 5,719 self-referred elderly subjects. To assess the frequency of hypercholesterolemia as a potential major public health problem in the elderly, we studied 5,719 self-referred subjects greater than age 60 and 11,890 less than or equal to 60 years, whose nonfasting capillary blood cholesterol levels were measured during an 18-month screening in Cincinnati area grocery stores. We followed National Cholesterol Education Program guidelines for serum cholesterol (less than 200 mg/dl "desirable," 200-239 "borderline-high," and greater than or equal to 240 mg/dl "high"). Of 4,011 61-70 year-olds, only 19% had capillary blood total cholesterol less than 200, 38% were 200-239, and 43% greater than or equal to 240 mg/dl. Of 1,493 aged 71-80 years, only 20% had total cholesterol less than 200, 36% had levels 200-239, and 44% were greater than or equal to 240 mg/dl. In 215 subjects, 81 and over, 29% had total cholesterol less than 200, 36% were 200-239, and 35% were greater than or equal to 240 mg/dl. Application of the non-age, non-race, non-sex specific National Cholesterol Education Program guidelines to the elderly may necessitate followup and perhaps therapy in 71-81% of subjects, suggesting that the appropriate intervention approach be general population-oriented, rather than the individual detection, diagnosis, and treatment approach which presents a huge, expensive load for a relatively unprepared health care community. 