Cho Kyuyoung, Chai Hye Won, Park Min Kyoung
Department of Child Development and Family Studies, Pusan National University, Busan, Republic of Korea.
Research Institute of Human Ecology, Pusan National University, Busan, Republic of Korea.
Front Public Health. 2025 Aug 20;13:1637180. doi: 10.3389/fpubh.2025.1637180. eCollection 2025.
The biopsychosocial model of dementia emphasizes an integrative approach that takes into account the joint effects of biological and behavioral processes relevant to cognitive function. Based on this model, this study examined the interactive effects of biological (i.e., high-density lipoprotein; HDL) and behavioral (i.e., frequency of walking) factors on cognitive function (measured using KDSQ-C) among South Korean (hereafter "Korean") older adults. We conducted a subgroup analysis to explore whether the interaction of these factors differs depending on older adults' history of chronic conditions.
This study used cross-sectional Korean National Health Insurance Service data from 2009 that included a sample of older adults who remained qualified for health insurance and medical aid ( = 20,162). Linear regression models that tested for the interaction effects between HDL and frequency of walking on cognition were analyzed separately for two groups - no history of hypertension or diabetes and those with a history of hypertension or diabetes.
Results showed significant interaction effects ( = -0.024, < 0.05) between HDL cholesterol and walking only among older adults with a history of chronic diseases. Specifically, more frequent engagement in walking buffered the negative effect of low HDL cholesterol on cognitive function for those with a history of hypertension or diabetes.
These findings show that regular walking significantly attenuates the negative impact of low HDL cholesterol on cognitive function among Korean older adults with a chronic disease history. This highlights the importance of developing tailored intervention programs that emphasize the health benefits of walking, particularly for older adults with hypertension and diabetes, to help mitigate cognitive decline and promote overall cognitive health.
痴呆症的生物心理社会模型强调一种综合方法，该方法考虑了与认知功能相关的生物和行为过程的联合效应。基于该模型，本研究考察了生物因素（即高密度脂蛋白；HDL）和行为因素（即步行频率）对韩国老年人认知功能（使用KDSQ-C进行测量）的交互作用。我们进行了亚组分析，以探讨这些因素的相互作用是否因老年人的慢性病病史而异。
本研究使用了2009年韩国国民健康保险服务的横断面数据，样本包括仍有资格享受健康保险和医疗救助的老年人（n = 20162）。分别对两组进行线性回归模型分析，以检验HDL与步行频率对认知的交互作用，这两组分别是无高血压或糖尿病病史的老年人以及有高血压或糖尿病病史的老年人。
结果显示，仅在有慢性病病史的老年人中，HDL胆固醇与步行之间存在显著的交互作用（β = -0.024，p < 0.05）。具体而言，对于有高血压或糖尿病病史的人来说，更频繁地步行缓冲了低HDL胆固醇对认知功能的负面影响。
这些发现表明，规律步行可显著减轻低HDL胆固醇对有慢性病病史的韩国老年人认知功能的负面影响。这凸显了制定针对性干预计划的重要性，这些计划强调步行对健康的益处，特别是对患有高血压和糖尿病的老年人，以帮助减轻认知衰退并促进整体认知健康。
