Details

Autor(en) / Beteiligte

• Zuliani, Giovanni
• Romagnoni, Franco
• Bollini, Cristina
• Leoci, Vincenzo
• Soattin, Lucia
• Fellin, Renato

Titel

Low Levels of High-Density Lipoprotein Cholesterol Are a Marker of Disability in the Elderly

Ist Teil von

• Gerontology (Basel), 1999-11, Vol.45 (6), p.317-322

Ort / Verlag

Basel, Switzerland: Karger

Erscheinungsjahr

1999

Quelle

MEDLINE

Beschreibungen/Notizen

• Background: In the elderly, high-density lipoprotein cholesterol (HDL-C) seems to have further clinical meanings besides the inverse relationship with coronary heart disease (CHD); indeed, low values have been found in elderly subjects with functional disability, chronic illness, and in severe clinical conditions. Objective: To verify the hypothesis that low HDL-C might be a ‘marker’ for disability, we evaluated the relationship between lipoprotein parameters and functional status, over a period of 2 years, in a large sample of institutionalized elderly. Methods: 344 institutionalized subjects aged over 65 years were studied. They were divided into two groups according to basal disability level: ‘low–mild’: class A–E, and ‘high’: class F–G of the Katz index. 124 survivors, independent in at least two basic activities of daily living (BADL) at enrollment, were divided into two groups on the basis of 2 years’ modifications in functional status: stable/improved or worsened (lost ≥2 BADL). Results: Total cholesterol, LDL-C, HDL-C, and apo A-I levels were lower in the high disability group, while no differences in triglycerides and apo B levels emerged. Multiple logistic regression analysis showed that severe disability was associated with HDL-C (II vs. III tertile: OR 2.01; CI 95% 1.04–3.91; I vs. III tertile: OR 2.52; CI 95% 1.23–5.15), total cholesterol (I vs. III tertile: OR 2.35; CI 95% 1.14–4.81), blood glucose (OR 0.98), and body mass index (OR 0.91), independently from uric acid, number of pathologies, number of drugs, body cell mass, vitamin B 12 and folic acid plasma levels, waist/hip ratio, age, and gender. Subjects who lost ≥2 BADL in the 2-year follow-up consistently showed lower basal HDL-C levels compared to subjects with stable/improved functional status, and this difference was significant after adjustment for basal Katz class, age, gender, number of pathologies, blood glucose, body mass index, and waist/hip ratio. Conclusions: The results of this study suggest that in the elderly severe disability is strongly associated with low HDL-C levels. Longitudinal data support the hypothesis that low HDL-C might be considered as a marker for ‘ongoing’ disability in BADL.