The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access published online on January 20, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, doi:10.1093/gerona/gln005
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Metabolic Syndrome and Physical Decline in Older Persons: Results from the Health, Aging and Body Composition Study
1 EMGO Institute/Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
2 The Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina
3 University of Pittsburgh, Pennsylvania
4 National Institute on Aging, Bethesda, Maryland
5 University of Tennessee, Memphis
6 Center for Disease Control, Atlanta, Georgia
7 University of California, San Francisco
8 University of Florida, Gainesville
Address correspondence to Brenda W. Penninx, PhD, EMGO Institute/Department of Psychiatry, VU University Medical Center, AJ Ernststraat 887, 1081 HL Amsterdam, The Netherlands. Email: b.penninx{at}vumc.nl
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Abstract |
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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 
3 of the following: (a) waist circumference >102 (men) or >88 cm (women); (b) triglycerides 150 mg/dL; (c) high-density lipoprotein cholesterol <40 mg/dL (men) or <50 mg/dL (women); (d) blood pressure 130/85 mm Hg or antihypertensive medication; and (d) fasting glucose 110 mg/dL or antidiabetic medication. Mobility limitation was defined as difficulty or inability walking 
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.
Keywords Metabolic syndrome; Obesity; Glucose; Mobility limitation; Older; Diabetes; Cerebrovascular disease
Received: July 24, 2007; Accepted: April 24, 2008