Frailty and Quality of Life in Older Adults with Metabolic Syndrome — Findings from the Healthy Older People Everyday (HOPE) Study

Objectives Metabolic syndrome (MetS) and frailty are both associated with increased morbidity and mortality. Frailty is associated with reduced quality of life (QoL) but association of QoL with MetS have produced mixed results suggesting that other factors such as disease burden, obesity and depress...

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Published in:The Journal of nutrition, health & aging health & aging, 2021-05, Vol.25 (5), p.637-644
Main Authors: Chen, M. Z., Wong, M. W. K., Lim, J. Y., Merchant, Reshma Aziz
Format: Article
Language:English
Subjects:
Aged
Aging
Cross-Sectional Studies
Diabetes
Female
Frailty
Frailty - epidemiology
Geriatrics/Gerontology
Health Status
Humans
Male
Medicine
Medicine & Public Health
Mental depression
Metabolic syndrome
Metabolic Syndrome - epidemiology
Neurosciences
Nutrition
Older people
Polypharmacy
Primary Care Medicine
Quality of Life
Quality of Life Research
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Summary:Objectives Metabolic syndrome (MetS) and frailty are both associated with increased morbidity and mortality. Frailty is associated with reduced quality of life (QoL) but association of QoL with MetS have produced mixed results suggesting that other factors such as disease burden, obesity and depression may have a more significant influence. We aim to investigate the demographics of frail participants with MetS, and relationship between frailty and QoL in MetS. Methods Cross-sectional population study involving 292 older adults ≥ 65 years with MetS. MetS was defined using the Modified ATP III for Asians which requires the presence of 3 or more of the following 5 components 1) waist circumference ≥ 90cm for males or ≥ 80cm for females, 2) TG ≥ 150mg/dL, 3) HDLc < 40mg/dL in males or < 50mg/dL in females, 4) blood pressure ≥ 130/85mmHg or use of anti-hypertensive medication, and 5) fasting plasma glucose ≥ 100mg/dL or use of pharmacological treatment for diabetes mellitus. Data were collected on demographics, frailty (FRAIL), QoL (Euroqol-5D), perceived health, functional status, cognition, Timed-Up-and-Go (TUG), and hand-grip strength (HGS). Results 40.4% of the participants were pre-frail (MetSprefrail) and 7.2% were frail (MetSfrail). MetSfrail were significantly older, had lower education level, higher polypharmacy burden and higher prevalence of diabetes. The prevalence of at least 1 activity of daily living impairment was 4 times higher, and depression 9 times higher than their robust counterparts. MetSfrail also had longer TUG, higher prevalence of poor grip strength and poor perceived health. After adjusting for age, gender and education, MetSfrail was significantly associated with much higher odds of EQ-5D moderate to extreme problems with mobility (Odds Ratio (OR) =10.99, CI 2.62–46.14), usual activities (OR=37.82, CI 3.77–379.04) and pain (OR=10.79, CI 3.18–36.62). EQ-5D Index Value and Perceived Health improved by 0.1 (Mean Difference (MD) =0.07, CI 0.04–0.10) and 6.0 (MD=6.01, CI 3.29–8.73) respectively as frailty status improved. Conclusion Frailty in MetS is associated with depression, polypharmacy, greater functional impairment, poorer QoL and perceived health. Frailty screening and personalized management is crucial in MetS as frailty may be a mediator for negative outcomes in MetS, and frailty may be reversible.
ISSN:1279-7707
1760-4788
DOI:10.1007/s12603-021-1609-3