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Background: In studies from Italy and Greece, a Mediterranean dietary pattern was shown to favorably affect life expectancy in the elderly population. This pattern is thought to reduce the risk of cancer in addition to being cardioprotective. Objective: The objective of this study was to evaluate the interactive effects of the Mediterranean diet and age with respect to survival after controlling for several other variables that could be considered as confounders: age, sex, body mass index, albumin concentration, physical activity, self-assessment of health, and dieting in response to chronic conditions. Design: This was a cohort study involving 161 nonsmoking elderly subjects (74 subjects aged [is less than] 80 y and 87 subjects aged [is greater than or equal to] 80 y) living in Spain. The subjects were followed up for [is greater than or equal to] 9 y. Diet was assessed with a semiquantitative food-frequency questionnaire. Results: A diet score based on 8 characteristics of the traditional diet in the Mediterranean region was associated with a significant reduction in overall mortality in elderly subjects aged [is less than] 80 y but not in subjects aged [is greater than or equal to] 80 y. A unit increase in the diet score predicted a 31% reduction in mortality in subjects aged [is less than] 80 y (95% CI: 7%, 57%). Conclusion: Efforts to promote adherence to the Mediterranean dietary pattern appear to be worthwhile in persons aged [is less than] 80 y, in whom the diet predicts survival, but we do not have any available evidence that such a diet benefits subjects aged[is greater than or equal to]80 y. Am J Clin Nutr 2000;71:987-92. KEY WORDS Dietary pattern, life expectancy, elderly, longitudinal study, Mediterranean diet, Spain, nonsmokers