Metabolic syndrome and insulin resistance are associated with frailty in older adults: a prospective cohort study.
Background
diabetes increases the risk of frailty that is a leading cause of disability and premature mortality in older people. Metabolic syndrome (MS) and insulin resistance (IR) are strong risk factors for diabetes and could, thus, lead to frailty. However, the association between MS or IR and frailty has barely been investigated.


Methods
data were obtained from a cohort of 1,499 community-dwelling individuals aged ≥60, who were free of diabetes at 2008-10 and were followed up for 3.5 years. At baseline, MS was ascertained according to the harmonised definition, and IR with the Homoeostatic Model Assessment for IR index (HOMA-IR). Frailty was defined as having three or more of the Fried's criteria: exhaustion, low physical activity, slow walking, unintentional weight loss and low grip strength. Statistical analyses were performed with logistic regression, and adjusted for the main confounders.


Results
in 2012, 84 cases of incident frailty were identified. Compared with subjects without MS, those with MS showed increased risk of frailty (multivariate odds ratio [OR]: 1.85; 95% confidence interval [CI] 1.12-3.05). The association persisted after further adjustment for fibrinogen and C-reactive protein. When the frailty criteria were considered individually, low grip strength was the criterion that showed a stronger association with MS (OR: 1.67; 95% CI: 1.25-2.21). Higher HOMA-IR values were also associated with higher risk of frailty.


Conclusion
MS and IR were associated with increased risk of frailty. This work extends the spectrum of harmful consequences of MS, and suggests that preventing or controlling MS may serve to delay frailty.
['Pérez-Tasigchana|Raúl F|RF|', 'León-Muñoz|Luz M|LM|', 'Lopez-Garcia|Esther|E|', 'Gutierrez-Fisac|Juan L|JL|', 'Laclaustra|Martín|M|', 'Rodríguez-Artalejo|Fernando|F|', 'Guallar-Castillón|Pilar|P|']
D000367:Age Factors D000368:Aged D000375:Aging D015415:Biomarkers D001777:Blood Coagulation D001786:Blood Glucose D002097:C-Reactive Protein D005260:Female D005340:Fibrinogen D016330:Frail Elderly D000073496:Frailty D015577:Geriatric Assessment D006801:Humans D015994:Incidence D018836:Inflammation Mediators D007328:Insulin D007333:Insulin Resistance D016015:Logistic Models D008297:Male D024821:Metabolic Syndrome D008875:Middle Aged D016017:Odds Ratio D011237:Predictive Value of Tests D011446:Prospective Studies D018570:Risk Assessment D012307:Risk Factors D013030:Spain D013997:Time Factors
metabolic syndrome insulin resistance Frailty cohort study older people abdominal obesity