title: Stroke-independent association between metabolic syndrome and functional dependence, depression, and low quality of life in elderly community-dwelling Brazilian people.
abstract: OBJECTIVE
  Metabolic syndrome (Met.S) is a risk factor for stroke, dementia, and ischemic heart disease (IHD). It is unclear whether Met.S is an independent risk factor for functional dependence, depression, cognitive impairment, and low health-related quality of life (HRQoL) in a population free of clinical stroke.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Two communities in southern Brazil.
  
  
  METHODS
  Four hundred twenty people aged 60 and older.
  
  
  METHODS
  An adapted (body mass index > or =30 kg/m(2) and blood pressure > or =140/90) Adult Treatment Panel III definition was used in diagnosing Met.S. Depression (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Revised) and Mini-Mental State Examination were evaluated along with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). HRQoL was measured using a visual analogue scale (0-10). All values were adjusted for age, sex, and presence of IHD.
  
  
  RESULTS
  Forty (9.5%) subjects had a stroke and were excluded from the final analysis. Met.S was present in 37.4% of the stroke-free population. Met.S was significantly and independently associated with 2.24 times as much ADL dependence, 2.39 times as much IADL dependence, a 2.12 times higher risk of depression, a 2.27 times higher likelihood of cognitive impairment, and a 1.62 times higher chance of low self-perceived HRQoL (all P<0.05). Adjustment for its own components reduced the strength of the above associations but did not eliminate their statistical significance. If Met.S were removed from this population, dependence, depression, cognitive impairment, and low QoL would be reduced 15.0% to 21.4%.
  
  
  CONCLUSIONS
  Met.S was significantly associated with functional dependence, depression, cognitive impairment, and low HRQoL, and its effects were independent of clinical stroke, IHD, and its own individual components.
authors.affiliation: Department of Neurology, Kyoto University, Kyoto, Japan. matheusroriz@hotmail.com
authors.forename: Matheus
authors.initials: M
authors.lastname: Roriz-Cruz
authors.forename: Idiane
authors.initials: I
authors.lastname: Rosset
authors.forename: Taizo
authors.initials: T
authors.lastname: Wada
authors.forename: Teiji
authors.initials: T
authors.lastname: Sakagami
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ishine
authors.forename: Jarbas S
authors.initials: JS
authors.lastname: Roriz-Filho
authors.forename: Thadeu R S
authors.initials: TR
authors.lastname: Cruz
authors.forename: Rosalina P
authors.initials: RP
authors.lastname: Rodrigues
authors.forename: Isvania
authors.initials: I
authors.lastname: Resmini
authors.forename: Shinji
authors.initials: S
authors.lastname: Sudoh
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Wakatsuki
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Souza
authors.forename: Toru
authors.initials: T
authors.lastname: Kita
authors.forename: Kozo
authors.initials: K
authors.lastname: Matsubayashi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology; D001938:Brazil; D002544:Cerebral Infarction / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D003906:Developing Countries; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D011788:Quality of Life; D013223:Statistics as Topic