title: Linking cognition and frailty in middle and old age: metabolic syndrome matters.
abstract: OBJECTIVE
  This study examined whether metabolic syndrome (MetS) would moderate the association of cognition with frailty in middle and old age.
  
  
  METHODS
  A cross-sectional design was used. Six hundred and ninety participants (age ≥ 50 years) from an on-going national survey were included in the study. Confirmatory factor analysis was applied to determine latent variables of executive function (EF), episodic memory (EM), and MetS based on relevant measurements. Frailty was defined using a modified form of Fried's criteria.
  
  
  RESULTS
  Applying structural equation modeling, having MetS significantly increased the likelihood of being frail. Better performance on EM tasks, but not EF, was significantly associated with lower likelihood of MetS. Worse performance on EF, but not EM, significantly increased the likelihood of being frail. There was a significant interacting effect between MetS and EF, but not EM, on frailty. Further contrast analysis indicated that having MetS strengthened the negative association between EF and frailty.
  
  
  CONCLUSIONS
  Metabolic syndrome moderates the relationship between EF and frailty. A prospecitve study is needed to validate such relationships before developing interventions targeting the prevention or treatment of EF and frailty in individuals with MetS.
authors.affiliation: School of Nursing, University of Rochester, Rochester, NY, USA; Department of Psychiatry, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA.
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.forename: Rachel
authors.initials: R
authors.lastname: Roiland
authors.forename: Ding-Geng Din
authors.initials: DG
authors.lastname: Chen
authors.forename: Christina
authors.initials: C
authors.lastname: Qiu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003071:Cognition / Q000502:physiology*; D003430:Cross-Sectional Studies; D056344:Executive Function / Q000502:physiology; D005163:Factor Analysis, Statistical; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged
keywords: episodic memory; executive function; frailty; metabolic syndrome
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