ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1637180
This article is part of the Research TopicBiomechanics of Aging: Advances in Exercise and Intervention Strategies for Older Adult WellnessView all 10 articles
The Moderating Role of Walking in the Association between HDL Cholesterol and Cognitive Function among Korean Older Adults: A Nationwide Population-Based Cross-sectional Study
Provisionally accepted
- 1Pusan National University, Geumjeonggu, Republic of Korea
- 2Clemson University, Clemson, United States
- 3Office of Long Term Services & Supports, Maryland Department of Health, Baltimore, United States
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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. Methods: 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 (n=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: Results showed significant interaction effects (β = -0.024, p < .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. Conclusions: 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.
Keywords: biopsychosocial perspectives, Cognitive Function, HDL cholesterol, Walking, Korean older adults
Received: 28 May 2025; Accepted: 31 Jul 2025.
Copyright: © 2025 Cho, Chai and Park. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hye Won Chai, Clemson University, Clemson, United States
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