DOES THE METABOLIC SYNDROME PREDICT MOBILITY IMPAIRMENT IN THE ELDERLY

The predictive importance of the metabolic syndrome and its components for declining mobility were tested in a 5-year follow-up study of fou r elderly birth cohorts (65, 75, 80 and 85 years of age; II = 946). In the age group of 65 years, the subjects with mobility decline were mo re often diabetics (24.6 vs. 15.5%, P = 0.060), had higher blood gluco se (6.2 vs. 5.8 mmol/l, P < 0.05), higher fasting plasma insulin (13.2 vs. 11.4 IU/I, P < 0.01), and higher body mass index (28.4 vs. 27.2 k g/m(2), P < 0.05) than the others. In the 75 year-old group, the mobil ity decline was associated with lower HDL-cholesterol (1.4 vs. 1.6 mmo l/l, P < 0.05) and higher insulin (15.9 vs. 12.8 IU/I, P < 0.10). In t he 80 year-old group, insulin was higher in subjects whose mobility de clined (11.3 vs. 17.9 IU/I, P < 0.05) but in the oldest group insulin tended to be lower in the subjects with declining mobility. In non-dia betic subjects, blood glucose and plasma insulin were associated with declining mobility in the 65 year-old cohort, only. After controlling for gender and baseline mobility, one quartile of both insulin and BMI increased the probability of mobility decline by 35%, mainly of diffi culties in walking up stairs. Of the components of metabolic syndrome, obesity and hyperinsulinemia as its consequence appear causal of decl ining mobility. (C) 1998 Elsevier Science Ireland Ltd. All rights rese rved.