Age and Ageing Advance Access published online on November 5, 2009
Age and Ageing, doi:10.1093/ageing/afp194
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Interaction of HDL cholesterol concentrations on the relationship between physical function and inflammation in community-dwelling older persons
1 Centro per la Salute dell'Anziano - Area di Geriatria, Università Campus Bio-Medico, Rome, Italy
2 Department of Aging and Geriatric Research, University of Florida - Institute on Aging, Gainesville, FL, USA
3 Dipartimento di Scienze Gerontologiche, Geriatriche e Fisiatriche, Università Cattolica del Sacro Cuore, Rome, Italy
Address correspondence to: M. Cesari, Centro per la Salute dell'Anziano - Area di Geriatria, Università Campus Bio-Medico, Via Alvaro del Portillo 5, 00128 Rome, Italy. Tel: +39 (06) 2254-1654; Fax: +39 (06) 2254-1602. E-mail: macesari{at}gmail.com
Background: the existence of a relationship among inflammation, high-density lipoprotein cholesterol (HDL-C) and physical function has been suggested.
Objective: the aim of the study is to investigate the possible interaction of HDL-C on inflammation and physical function.
Design: cross-sectional study.
Setting: town of Tuscania (Italy).
Subjects: all the 329 community-dwelling older persons aged 
75 years (mean age 79.8 ± 5.2 years, women 56.2%).
Methods: HDL-C, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and interleukin-6 (IL-6) were measured. Activities of daily living (ADL), instrumental ADL (IADL) and 4-m walking speed were assessed. Linear regression models were performed.
Results: given the multiple significant interactions, models were stratified according to HDL-C concentrations. In participants with normal HDL-C concentrations, only IL-6 showed a significant association with IADL (β = –0.439, SE = 0.176, P = 0.01). In participants with low HDL-C concentrations, all three inflammatory biomarkers were significantly associated with 4-m walking speed and IADL. IL-6 was also significantly associated with ADL (β = –0.755, SE = 0.259, P = 0.006), whereas borderline significances were reported for CRP and ESR.
Conclusions: the association between inflammation and physical function is particularly enhanced in elders with low HDL-C concentrations. Though HDL-C may merely act as a wellbeing index, HDL-C concentrations should be considered in studies evaluating inflammation and physical function.
Keywords: HDL cholesterol, physical function, inflammation, older persons, elderly
Received 4 February 2009; accepted in revised form 23 September 2009.