The Association between Metabolic Syndrome, Frailty and Disability-Free Survival in Healthy Community-dwelling Older Adults

A. R.M.Saifuddin Ekram, S. E. Espinoza, M. E. Ernst, J. Ryan, L. Beilin, N. P. Stocks, S. A. Ward, J. J. McNeil, R. C. Shah, R. L. Woods

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objectives: To examine the association between metabolic syndrome (MetS) and frailty, and determine whether co-existent MetS and frailty affect disability-free survival (DFS), assessed through a composite of death, dementia or physical disability. Design: Longitudinal study. Setting and Participants: Community-dwelling older adults from Australia and the United States (n=18,264) from “ASPirin in Reducing Events in the Elderly” (ASPREE) study. Measurements: MetS was defined according to American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines (2018). A modified Fried phenotype and a deficit accumulation Frailty Index (FI) were used to assess frailty. Association between MetS and frailty was examined using multinomial logistic regression. Cox regression was used to analyze the association between MetS, frailty and DFS over a median follow-up of 4.7 years. Results: Among 18,264 participants, 49.9% met the criteria for MetS at baseline. Participants with Mets were more likely to be pre-frail [Relative Risk Ratio (RRR): 1.22; 95%Confidence Interval (CI): 1.14, 1.30)] or frail (RRR: 1.66; 95%CI: 1.32, 2.08) than those without MetS. MetS alone did not shorten DFS while pre-frailty or frailty alone did [Hazard Ratio (HR): 1.68; 95%CI: 1.45, 1.94; HR: 2.65; 95%CI:1.92, 3.66, respectively]. Co-existent MetS with pre-frailty/frailty did not change the risk of shortened DFS. Conclusions: MetS was associated with pre-frailty or frailty in community-dwelling older individuals. Pre-frailty or frailty increased the risk of reduced DFS but presence of MetS did not change this risk. Assessment of frailty may be more important than MetS in predicting survival free of dementia or physical disability.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalJournal of Nutrition, Health and Aging
Issue number1
StatePublished - Jan 2023


  • Fried phenotype
  • deficit accumulation frailty index
  • dementia
  • disability-free survival
  • metabolic syndrome
  • physical disability

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Nutrition and Dietetics
  • Medicine (miscellaneous)


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