Metabolic Age as a Potential Marker of Cardiometabolic Vulnerability in Institutionalised Older Adults: A Cross-Sectional Study

Abstract

Background/Objectives: Chronological age is a major determinant of cardiovascular risk and metabolic syndrome, but it may not accurately reflect biological ageing or cardiometabolic vulnerability. Metabolic age has emerged as a potential indicator of metabolic health, although its relationship with cardiometabolic risk in institutionalised older adults remains poorly understood. This study examined the association of metabolic age with cardiovascular risk and metabolic syndrome and compared its performance with that of chronological age. Methods: A cross-sectional observational study was conducted in residential care facilities in Spain between 2023 and 2024. Fifty-five institutionalised older adults underwent anthropometric and body composition assessment using bioelectrical impedance analysis. Cardiovascular risk was estimated using the Systematic Coronary Risk [EE1.1]Evaluation 2–Older Persons (SCORE2-OP) model, and metabolic syndrome was diagnosed according to harmonised clinical criteria. Logistic regression, receiver operating characteristic curve analyses, and discriminant analyses were performed. Results: Metabolic age was significantly higher in participants with cardiovascular risk and metabolic syndrome, whereas chronological age showed no significant associations. Metabolic age was significantly associated with both outcomes and showed discriminatory ability within the present sample, whereas chronological age was not significantly associated with either outcome. Leg muscle mass index, body mass index, and visceral fat were the body composition variables most strongly associated with cardiometabolic risk. Higher metabolic age was associated with greater visceral adiposity, and lower leg muscle mass characterised participants with the most adverse cardiometabolic profiles. Conclusions: Metabolic age may be a more informative indicator of cardiometabolic vulnerability than chronological age in institutionalised older adults. Combined with body composition assessment, it may provide complementary information for identifying adverse cardiometabolic profiles in ageing populations.