HDL Cholesterol is Independently Associated with Cognitive Function in Males but Not in Females within a Cohort of Nonagenarians: The Mugello Study

Background The association between lipid concentrations and cognitive function in elderly has shown inconsistent results. Aim To investigate the possible relationship between lipid profile and cognitive functions in a cohort of nonagenarians enrolled within the Mugello Study, an epidemiological study aimed at investigating both clinically relevant geriatric items and various health issues Methods Three hundred twenty-five nonagenarians (218 F, median age: 92 years) were evaluated through laboratory, instrumental examinations and questionnaires concerning lifestyle, dietary habits and cognitive status Results Females are older, with a lower level of education, live more prevalently on their own and have higher values for total cholesterol and HDL cholesterol compared to males. With regard to functional and cognitive measures females report a significantly lower skill level in the physical activity performance, with a level of independence that is better for both basic and instrumental activities. In order to investigate whether there was an association between lipid variables and cognitive function as measured by the Mini-Mental State Examination (MMSE) a multiple regression analysis was performed with adjustments for confounding variables based on gender. In males, HDL cholesterol showed a significant relationship with MMSE after a complete adjustment with years of education, physical activity performance and daily living activities (β = 0.174; p=0.037). In females HDL cholesterol showed a significant association only in the model adjusted for age and BMI, losing its associations as soon as the cohabitation state and the depression status entered the model. Conclusion Our results support the hypothesis that HDL cholesterol is significantly linked to cognitive functions, especially in males of a cohort of very old people.