Stroke-Independent Association Between Metabolic Syndrome and Functional Dependence, Depression, and Low Quality of Life in Elderly Community-Dwelling Brazilian People

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 55; no. 3; pp. 374 - 382
• Main Authors: Roriz-Cruz, Matheus, Rosset, Idiane, Wada, Taizo, Sakagami, Teiji, Ishine, Masayuki, Roriz-Filho, Jarbas S., Cruz, Thadeu R. S., Rodrigues, Rosalina P., Resmini, Isvania, Sudoh, Shinji, Wakatsuki, Yoshio, Nakagawa, Masanori, Souza, Antonio C., Kita, Toru, Matsubayashi, Kozo
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.03.2007; Blackwell; Wiley Subscription Services, Inc
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Alzheimer Disease - epidemiology; Biological and medical sciences; Brazil; Cerebral Infarction - epidemiology; cognitive impairment; Comorbidity; Cross-Sectional Studies; Dementia; depression; Depressive Disorder - epidemiology; Developing Countries; Disability Evaluation; Female; functional dependence; General aspects; Health Surveys; Humans; Male; Mass Screening; Medical sciences; Mental depression; Metabolic diseases; Metabolic syndrome; Metabolic Syndrome - epidemiology; Middle Aged; Miscellaneous; Neurology; Older people; Other metabolic disorders; QoL; Quality of Life; Risk factors; Statistics as Topic; Stroke; Vascular diseases and vascular malformations of the nervous system; South America; Brazil; America; Endocrinopathy; Cognitive disorder; Cardiovascular disease; QoL; Vascular disease; Association; X Syndrome; At home; Functional dependence; Cerebrovascular disease; Mood disorder; Human; Nervous system diseases; Stroke; Metabolic diseases; Depression; Housing; Cerebral disorder; Quality of life; metabolic syndrome; Gerontology; Low; Central nervous system disease; cognitive impairment; Elderly; Geriatrics
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/j.1532-5415.2007.01068.x

OBJECTIVES: Metabolic syndrome (Met.S) is a risk factor for stroke, dementia, and ischemic heart disease (IHD). It is unclear whether Met.S is an independent risk factor for functional dependence, depression, cognitive impairment, and low health‐related quality of life (HRQoL) in a population free of clinical stroke. DESIGN: Cross‐sectional. SETTING: Two communities in southern Brazil. PARTICIPANTS: Four hundred twenty people aged 60 and older. MEASUREMENTS: An adapted (body mass index ≥30 kg/m2 and blood pressure ≥140/90) Adult Treatment Panel III definition was used in diagnosing Met.S. Depression (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Revised) and Mini‐Mental State Examination were evaluated along with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). HRQoL was measured using a visual analogue scale (0–10). All values were adjusted for age, sex, and presence of IHD. RESULTS: Forty (9.5%) subjects had a stroke and were excluded from the final analysis. Met.S was present in 37.4% of the stroke‐free population. Met.S was significantly and independently associated with 2.24 times as much ADL dependence, 2.39 times as much IADL dependence, a 2.12 times higher risk of depression, a 2.27 times higher likelihood of cognitive impairment, and a 1.62 times higher chance of low self‐perceived HRQoL (all P<0.05). Adjustment for its own components reduced the strength of the above associations but did not eliminate their statistical significance. If Met.S were removed from this population, dependence, depression, cognitive impairment, and low QoL would be reduced 15.0% to 21.4%. CONCLUSION: Met.S was significantly associated with functional dependence, depression, cognitive impairment, and low HRQoL, and its effects were independent of clinical stroke, IHD, and its own individual components.