A mixed study of the assessment of factors affecting metabolic syndrome based on latent class anaysis and explanatory-parallel method among elderly population in Yazd city

Abstract

Introduction Chronic diseases and metabolic disorders are prevalent health concerns that often escalate with increasing age and thus affect older individuals metabolic syndrome is one of the disorders that can lead to increased mortality and disability in the elderly and reduce their quality of life. In recent years, Iran has faced the rapid growth of the elderly population, which highlights the importance of dealing with metabolic syndrome.

Objective The current study aimed to evaluate lifestyle patterns and lifestyle risk factors among patients with metabolic syndrome (MetS) based on dietary, physical activity, and smoking, as well as MetS components. Methods and Materials This research was a follow-up sequential explanatory mixed method study that was carried out in 1401 in two quantitative and qualitative stages.Ten health centers were randomly selected from a total of 28 health centers. And 967 elderly people were randomly selected and included in the study. Among these people, 582 people were diagnosed with metabolic syndrome. Then, three risk factors related to lifestyle were used to identify the latent class pattern, which included food pattern, physical activity and smoking. For this purpose, to determine the nutritional pattern of the elderly with metabolic syndrome from the factor analysis method.After completing the consent and then Semi-quantitative food frequency, International Physical Activity Questionnaire and general questionnaires for all participants, their anthropometric characteristics were determined. Factor analysis was used to identify major dietary patterns. Data analyzed using SPSS version 24 and R (poLCA R (version 3.4.2)) by employing variety of tests including descriptive statistics, Kolmogorov-Smirnov test, Kruskal-Wallis test and regression. The significance level for all the tests were considered p<0.05. A qualitative study was conducted with the directed content analysis approach with the aim of explaining the factors affecting metabolic syndrome in the elderly belonging to subgroups with high-risk and low-risk lifestyles. A total of 32 elderly people with metabolic syndrome (12 people in the low-risk group and 20 people in the high-risk group) were purposefully selected for the study. The data were collected through semi structured interviews and analyzed using a deductive approach (in the form of a pre-designed coding matrix). Results The average age of the participants in the quantitative phase was 72.71 ± 5.57 years. Two high-fat food patterns and traditional food pattern were identified among the elderly. Two latent classes were observed in terms of lifestyle status among the elderly. The result of a qualitative study showed 526 primary codes (223 codes related to the low-risk group and 303 codes related to the high-risk group) that were included in the form of a coding matrix designed in the 3 main categories of physical activity, nutrition and smoking (based on predetermined factors). Individual factors such as false beliefs and ignorance, not having enough time and lack of motivation, also social and environmental factors were the main causes of adopting an unhealthy lifestyle. Conclusion The comparison of the reasons of both groups shows that false beliefs and lack of knowledge about a healthy lifestyle, lack of access to facilities and facilities related to a healthy lifestyle, as well as social and environmental factors are among the most important reasons for adopting an unhealthy lifestyle in the elderly.