Physical activity is negatively associated with the metabolic syndrome in the elderly

Background: An inverse association between physical activity and metabolic syndrome has been reported in several cohorts, but very few specific studies are available in the elderly, in whom neurological and musculo-skeletal diseases are expected to lead to a remarkable age-related decline of physical activity. Aim and Design: The relationships among physical activity, insulin resistance and metabolic syndrome were assessed in a cross-sectional study concerning 1144 subjects aged 65-91 years resident in Pianoro (northern Italy). Household and leisure-time activities were assessed by a self-administered questionnaire (Physical Activity Scale for Elderly-PASE). Routine clinical and biochemical data (including fasting insulin) were used to assess insulin resistance [Homeostasis Model Assessment (HOMA) method] and the prevalence of metabolic syndrome. Results: All PASE scores were inversely correlated with waist circumference, triglycerides and HOMA index, with highest significance for leisure-time activities (P <= 0.005). The PASE score for household activities was also correlated inversely with blood glucose (P < 0.05), and directly with HDL cholesterol (P < 0.001). In logistic regression analysis, the metabolic syndrome was more prevalent among sedentary subjects (corresponding to the low tertile of leisure-time activities) than in the remaining more active population (odds ratio 1.51, 95% confidence interval 1.12-2.03, P = 0.007), independently of possible confounders. Conclusion: Physical activity is inversely associated with insulin resistance and the metabolic syndrome even in the elderly. Community programs favoring physical activity are expected to significantly improve the health status in these subjects.