This study aimed to determine whether certain lifestyle factors, specifically alcohol consumption, smoking, physical activity, sleep duration and sleep quality, are associated with an increased risk of metabolic syndrome (MetS) and to assess how changes in lifestyle behaviours over time influence MetS prevalence in the middle-aged Korean population.

Community-based, prospective cohort study.

South Korea, baseline in 2017–2019 and follow-up in 2020–2022.

The study included 1436 adult individuals aged ≥30–59 years.

The primary outcome of this study was the prevalence of MetS at follow-up, determined according to established diagnostic criteria. Secondary outcomes included the association between MetS and five key lifestyle factors: alcohol consumption, smoking, physical activity, sleep quality and sleep duration. Lifestyle changes were categorised into four groups based on stability between baseline and follow-up assessments. Outcome measures remained consistent with the study’s initial protocol, with no modifications to the planned variables or measured criteria.

The prevalence of MetS increased from 15.3% at baseline to 19.6% at follow-up. At follow-up, insufficient physical activity (OR=1.42, 95% CI 1.06 to 1.92) and poor sleep quality (OR=1.37, 95% CI 1.02 to 1.84) were significantly associated with MetS. Among lifestyle change patterns, long-term unhealthy physical activity (OR=1.57, 95% CI 1.03 to 2.39) and sleep quality (OR=1.50, 95% CI 1.01 to 2.24) behaviours were associated with an increased risk of MetS. Poisson regression analyses of incident cases showed that only unfavourable changes in sleep duration were significantly associated with incident MetS (rate ratios=1.74, 95% CI 1.02 to 2.95). However, no significant associations were observed for other lifestyle change patterns, including behaviours that improved or worsened over time, and no meaningful associations were identified for non-significant lifestyle factors, such as smoking and alcohol consumption.

The prevalence of MetS was associated not only with individual lifestyle factors but also with long-term patterns of unhealthy behaviours, with persistent shortage of physical activity, poor sleep quality and inadequate sleep duration identified as significant contributors to increased MetS risk. Future research should explore a broader range of risk factors over longer follow-up periods to better understand the long-term impact of lifestyle modifications on MetS development.

A growing number of community-dwelling older adults living alone face a range of physical, psychological and social challenges that negatively impact their well-being. Various technologies have been developed to support healthy ageing, with voice-activated technology (VAT) offering particularly promising opportunities to improve later life well-being. However, its effect on older adults living alone has not yet been systematically evaluated. Thus, this study aims to provide an evidence base for the effectiveness of VAT interventions in enhancing the physical, psychological and social well-being of older adults living alone.

We will conduct a systematic review and meta-analysis of studies examining the use of VAT interventions among older adults living alone. The eligible study designs include randomised controlled trials and quasi-experimental studies. Primary outcomes will focus on physical, psychological and social well-being. A comprehensive search will be conducted across international (PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, ProQuest and Web of Science) and Korean databases (RISS, DBpia and KISS). Two reviewers will independently conduct study selection, risk-of-bias assessment and data extraction. A meta-analysis will be conducted to synthesise the effects of VAT interventions on psychological, physical and social domains of well-being.

Synthesising existing evidence, this review aims to inform the development of targeted interventions and support strategies to improve the well-being of older adults living alone. As no new data will be collected, ethical approval is not required. Findings will be published in a peer-reviewed journal to guide targeted intervention strategies and engage both academic and policy audiences.

CRD420251084621.