Metabolic Syndrome Duration and Risk of Frailty among Midlife Women: The Study of Women’s Health Across the Nation (SWAN)

Abstract

Background Metabolic syndrome is associated with frailty in older adults, with few data among midlife women. We examined metabolic syndrome (MetSyn), including duration, for associations with the development of prefrailty and frailty. Methods The Study of Women’s Health Across the Nation is a multiethnic, longitudinal cohort study of women aged 42-52 years at the time of enrollment (1996-1997). MetSyn was measured longitudinally, using ATP III criteria, starting at baseline. Pre-frailty and frailty were measured at two later visits (2012/13 and 2015/16) using Fried criteria. Associations of pre-frailty and frailty with prevalent MetSyn, the cumulative number of prior visits with MetSyn, and individual MetSyn criteria were examined using multivariable models. Results A total of 1,769 women were included (mean age 59.7 years, standard deviation [SD] 3.3). The adjusted odds ratios (aOR) for having pre-frailty or frailty in women with MetSyn compared to those without were 2.77 (95% confidence interval [CI], 2.19-3.50) and 8.73 (95% CI, 5.89-12.95), respectively. Each additional visit a woman met criteria for MetSyn was associated with a higher odds of pre-frailty and frailty (aOR 1.20; 95% CI: 1.14-1.26, and aOR 1.41; 95% CI: 1.33-1.50, respectively). Individual MetSyn criteria were also associated with the risk of frailty. Conclusion Among women in this multiethnic cohort, MetSyn was common during midlife and strongly associated with future development of pre-frailty and frailty while women were in their early sixties. Measurement of MetSyn during midlife can help identify women at high risk for developing frailty early in the aging process.