Metabolic syndrome is a cluster of cardiometabolic risk factors associated with increased risk of multiple chronic diseases, including cancer and cardiovascular disease. The objectives of this study were to estimate the prevalence of metabolic syndrome overall, by race and sex, and to assess trends in prevalence from 1988 through 2012. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) for 1988 through 2012. We defined metabolic syndrome as the presence of at least 3 of these components: elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, high blood pressure, and elevated fasting blood glucose. Data were analyzed for 3 periods: 1988-1994, 1999-2006, and 2007-2012. Among US adults aged 18 years or older, the prevalence of metabolic syndrome rose by more than 35% from 1988-1994 to 2007-2012, increasing from 25.3% to 34.2%. During 2007-2012, non-Hispanic black men were less likely than non-Hispanic white men to have metabolic syndrome (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.66-0.89). However, non-Hispanic black women were more likely than non-Hispanic white women to have metabolic syndrome (OR, 1.20; 95% CI, 1.02-1.40). Low education level (OR, 1.56; 95% CI, 1.32-1.84) and advanced age (OR, 1.73; 95% CI, 1.67-1.80) were independently associated with increased likelihood of metabolic syndrome during 2007-2012. Metabolic syndrome prevalence increased from 1988 to 2012 for every sociodemographic group; by 2012, more than a third of all US adults met the definition and criteria for metabolic syndrome agreed to jointly by several international organizations.

Objective: Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. Methods: We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. Results: During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71–1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96–1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96–3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00–2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. Conclusion: One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.