Metabolic syndrome in Korean older adults: Prevalence, determinants, and nursing implications

To estimate prevalence and identify determinants of metabolic syndrome (MetS) in Korean older adults (≥65 years), with actionable implications for gerontological nursing.

We analyzed 2023 Korea National Health and Nutrition Examination Survey (KNHANES) data. Of 6,929 respondents, 1,641 adults aged ≥65 years with complete data were included. MetS followed ATP III criteria adapted for Korean cutoffs. Independent variables spanned sociodemographic (age, sex, education, income, residence), behavioral (smoking, alcohol use, physical activity, sleep), and biological factors (25(OH)D₃, BMI). Survey-weighted multivariable logistic regression estimated adjusted odds ratios (aORs) with 95% CIs (α=.05).

MetS prevalence was approximately 42%. Higher odds were observed for age ≥72 years (aOR=1.27, 95% CI 1.00-1.62, p=.047) and BMI ≥25 kg/m² (aOR=6.92, 95% CI 5.51-8.69, p<.001). Lower odds were seen for male sex (aOR=0.74, 95% CI 0.58-0.95, p=.020), meeting WHO physical activity recommendations (aOR=0.70, 95% CI 0.52-0.95, p=.021), sleep ≥7 h/night (aOR=0.73, 95% CI 0.59-0.92, p=.007), and serum 25(OH)D₃ ≥20 ng/mL (aOR=0.68, 95% CI 0.53-0.87, p=.002). Income, education, residence, smoking, and alcohol were not significant.

MetS is common among Korean older adults, with obesity the dominant risk factor and modifiable behaviors (physical activity, sleep, vitamin D) showing protective associations. Gerontological nursing should prioritize: (1) nurse-led screening (waist circumference, blood pressure, glucose, lipids); (2) brief counseling on WHO-aligned activity, sleep hygiene, weight management, and vitamin D optimization; and (3) scalable referral pathways-including rural adaptations-to reduce disparities and support healthy aging.