Association between adherence to a 12-week multicomponent exercise program and changes in high-density lipoprotein cholesterol in community-dwelling older adults

Background and Purpose: Attendance at supervised sessions alone may not fully reflect adherence to home-based exercise. This study examined the association between multicomponent exercise adherence quantified from an 84-day diary and changes in high-density lipoprotein cholesterol (HDL-C). Methods: Seventy-five community-dwelling older adults (mean age 73.2 ± 6.7 years; 50 women) completed a 12-week program comprising weekly supervised exercise plus home-based step exercise, resistance exercise, and stretching. Participants were asked to maintain usual dietary habits. A composite adherence score was created from standardized exposure to the three exercise components. Participants were classified as Low (0 criteria, n = 15), Intermediate (1–2 criteria, n = 32), or High (3 criteria, n = 28). Regression analyses adjusted for age, sex, and baseline HDL-C. Results: HDL-C increased from 70.2 ± 17.0 to 74.3 ± 18.6 mg/dL (mean change +4.1 ± 8.0 mg/dL, p < 0.001). Mean changes were −2.5, +5.1, and +6.6 mg/dL in the Low, Intermediate, and High groups (unadjusted between-group p < 0.001). Each 1-SD increase in the composite score was associated with a 5.23-percentage-point greater percentage change in HDL-C (95% CI 2.70–7.76, p < 0.001). Adjusted changes were greater in the Intermediate and High groups than in the Low group; High and Intermediate did not differ (p = 0.193). Conclusion: Greater adherence across multiple exercise components was associated with larger HDL-C increases, but causality cannot be established without a non-exercise control group.