The Impact of Frailty and Metabolic Syndrome on Mortality Among Older Adults: A Five-Year Prospective Cohort Study

<b><i>Background:</i></b> Frailty and metabolic syndrome (MetS) are common conditions in older adults and may share overlapping pathophysiological pathways that impact mortality. <b><i>Objectives:</i></b> We aimed to investigate the effect of frailty and MetS on mortality the older adults. <b><i>Methods:</i></b> This study included 1100 outpatients aged ≥60 years. We followed the participants for five years, during which 13.2% of them died. The status of MetS was assessed using the criteria established by the National Cholesterol Education Program Third Adult Treatment Panel. We evaluated frailty using the FRAIL scale. <b><i>Results:</i></b> Mean age was 71.57 ± 7.09 years. The frail group had a significantly higher mean age (73.13 ± 7.75) compared to the nonfrail (70.20 ± 6.23) and prefrail (70.86 ± 6.73) groups (<i>P</i> < 0.001). In all three groups, women made up the majority, but in the frail group (76.9%), there were significantly more women than other groups (<i>P</i> < 0.001). MetS was more prevalent in prefrail and frail groups compared to those who were nonfrail (nonfrail: %59.1, prefrail: %71, frail: %70.2) (<i>P</i> = 0.010). The frail group showed a higher frequency of cognitive impairment, depressive mood, malnutrition, and dependency. The overall mortality rate for the sample was 13.2%, as anticipated, the frail group has a significantly higher mortality rate (23.4%) compared to the other two groups (nonfrail: 5.3%, prefrail: 10.2%) (<i>P</i> < 0.001). The Cox proportional hazards model indicated that the frail group demonstrated an increased mortality risk over five years, even after adjusting for age, sex, and metabolic disorders (hazard ratio: 4.44, 95% confidence interval = 2.19-9.02, <i>P</i> < 0.001). <b><i>Conclusions:</i></b> Frailty was a more accurate predictor of mortality than MetS, regardless of age.