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Psychosocial Risk Factors and the Metabolic Syndrome in Elderly Persons: Findings From the Health, Aging and Body Composition Study

¹ Department of Psychiatry and Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands.
² Wake Forest University School of Medicine, Winston-Salem, North Carolina.
³ University of Pittsburgh, Pennsylvania.
⁴ University of Florida and Veteran's Affaires Medical Center, Gainesville.
⁵ University of California, San Francisco.
⁶ National Institute on Aging, Bethesda, Maryland.
⁷ University of Tennessee, Memphis.
⁸ National Institute on Aging, Baltimore, Maryland.

Address correspondence to Nicole Vogelzangs, MSc, Department of Psychiatry and EMGO Institute, VU University Medical Center, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands. E-mail: nicolev{at}ggzba.nl

Background. Psychosocial factors have been associated with metabolic abnormalities that increase the risk of cardiovascular disease and diabetes. This study investigated the cross-sectional relationship between psychosocial risk factors and the metabolic syndrome in a community-based sample of older persons.

Methods. Participants were 2917 persons aged 70–79 years enrolled in the Health, Aging and Body Composition study. Depressive and anxiety symptoms, negative life events, and inadequate emotional support were assessed, and a summary psychosocial risk index was calculated. Metabolic syndrome was defined as three or more of the following criteria: abdominal obesity, high triglycerides, low high-density lipoprotein (HDL) cholesterol, high fasting glucose, and high blood pressure.

Results. Negative life events and inadequate emotional support increased the odds of having metabolic syndrome after adjustment for demographic and lifestyle variables (odds ratio [OR] per life event = 1.13, 95% confidence interval [CI] = 1.05–1.22; OR = 1.35, 95% CI = 1.10–1.66, respectively). The relationship between depressive symptoms and metabolic syndrome was only found in white (OR per standard deviation [SD] = 1.11, 95% CI = 1.01–1.23), but not in black (OR per SD = 0.97, 95% CI = 0.86–1.11) persons. Anxiety symptoms were significantly associated with metabolic syndrome in men (OR per SD = 1.13, 95% CI = 1.00–1.28), but not in women (OR per SD = 0.98, 95% CI = 0.89–1.08). Moreover, a higher score on the psychosocial risk index was associated with an increased probability of having the metabolic syndrome (OR = 1.30, 95% CI = 1.12–1.52).

Conclusions. In the elderly population, different psychosocial risk factors are associated with a higher prevalence of the metabolic syndrome. Whether reduction or better management of psychosocial risk factors can improve the metabolic profile remains to be demonstrated.

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