Metabolic syndrome and physical decline in older persons: results from the Health, Aging And Body Composition Study.
BACKGROUND
The metabolic syndrome includes dyslipidemia, abdominal obesity, insulin resistance, and hypertension and is associated with an increased risk of diabetes and cerebrovascular disease (CVD), but consequences beyond these outcomes have not been examined extensively. We investigated whether metabolic abnormalities have independent consequences on loss of mobility function of older persons.


METHODS
Data are from 2,920 men and women, 70-79 years, participating in the Health ABC study without mobility limitations at baseline. Metabolic syndrome was defined as > or =3 of the following: (a) waist circumference >102 (men) or >88 cm (women); (b) triglycerides > or =150 mg/dL; (c) high-density lipoprotein cholesterol <40 mg/dL (men) or <50 mg/dL (women); (d) blood pressure > or =130/85 mm Hg or antihypertensive medication; and (d) fasting glucose > or =110 mg/dL or antidiabetic medication. Mobility limitation was defined as difficulty or inability walking (1/4) mile or climbing 10 steps during two consecutive semiannual assessments over 4.5 years.


RESULTS
The prevalence of metabolic syndrome was 38.6%. The metabolic syndrome was associated with an adjusted relative risk (RR) of 1.46 (95% confidence interval [CI] = 1.30-1.63) for developing mobility limitations. The risk increased when more metabolic syndrome components were present (p trend >.001). All metabolic syndrome components were significantly associated with incident mobility limitations with the highest RRs for abdominal obesity (RR = 1.54, 95% CI = 1.35-1.75) and hyperglycemia (RR = 1.44, 95% CI = 1.27-1.63). Findings were unchanged when persons with baseline, or incident, CVD, stroke, or diabetes were excluded.


CONCLUSIONS
Metabolic syndrome abnormalities, especially abdominal obesity and hyperglycemia, are predictive of mobility limitations in the elderly, independent of CVD or diabetes.
Penninx
Brenda W J H
BW
EMGO Institute/Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands. b.penninx@vumc.nl
Nicklas
Barbara J
BJ
Newman
Anne B
AB
Harris
Tamara B
TB
Goodpaster
Bret H
BH
Satterfield
Suzanne
S
de Rekeneire
Nathalie
N
Yaffe
Kristine
K
Pahor
Marco
M
Kritchevsky
Stephen B
SB
D000368:Aged; D000375:Aging / Q000502:physiology*; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology; D001823:Body Composition / Q000502:physiology*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D051346:Mobility Limitation; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology
D001786:Blood Glucose; D008055:Lipids