**Background:** Modern societies are aging, and older adults face increased risks of disease and disability driven by poor diet, physical inactivity, and socio-demographic factors. Metabolic multimorbidity (e.g., hypertension, dyslipidemia, obesity) and mobility limitations are highly prevalent and associated with reduced quality of life and increased mortality. While many studies focus on institutionalized elderly, less research addresses community-dwelling older adults. This study aimed to investigate associations between socio-demographic characteristics, diet, physical activity, and the prevalence of metabolic disease and mobility impairment in Polish elderly living at home.
**Methods:** A cross-sectional survey was conducted from May to July 2021 in two Polish regions (Świętokrzyskie and Śląskie/Dolnośląskie). Using snowball sampling, 900 questionnaires were distributed via senior organizations; 466 were returned, and 417 were analyzed after excluding 49 with missing responses. Inclusion criteria were age ≥60 years and community residence. The questionnaire assessed: presence of doctor-diagnosed metabolic disease (e.g., diabetes, hypertension, atherosclerosis, obesity) and mobility-impairing disease (yes/no); nutritional factors using selected SCREEN-14 items (meal skipping, fruit/vegetable intake, protein-rich food frequency, dairy consumption, fluid intake, chewing/swallowing difficulties); socio-demographics (gender, age, education, residence, occupational status); financial situation (below average/average/above average); self-reported health (worse/same/better than peers); BMI (normal 18.5–24.9, overweight 25.0–29.9, obesity ≥30.0 kg/m²); family status and relations; dieting; alcohol frequency; and physical activity during leisure and non-leisure time (low/moderate/high). K-means cluster analysis grouped participants by disease status. Chi-square tests compared clusters, and logistic regression estimated odds ratios (OR) for metabolic and mobility-impairing disease. Significance was set at p<0.05.
**Key Results:** The sample was 74.8% women, mean age 70.8 years (SD 6.73). Overall, 52.3% reported metabolic disease, 21.1% reported mobility-impairing disease, 48.9% were overweight, and 24.0% were obese. Four clusters emerged: metabolic disease only (n=153), neither disease (n=176), both diseases (n=65), and mobility-impairing disease only (n=23). Clusters differed significantly by age, family status, financial status, employment, family relations, self-reported health, BMI, swallowing/chewing difficulties, and several dietary and physical activity variables (all p<0.05). Logistic regression showed that metabolic disease was significantly associated with overweight (OR 1.93, 95% CI 1.16–3.22, p=0.011), obesity (OR 3.13, 95% CI 1.67–5.88, p<0.001), and following a diet (OR 3.01, 95% CI 1.18–5.11, p<0.001). Perceiving health as same as peers (OR 0.32, 95% CI 0.16–0.63, p<0.001) or better than peers (OR 0.37, 95% CI 0.17–0.82, p=0.015) reduced the odds. Mobility impairment was significantly less likely among those with high school education (OR 0.30, 95% CI 0.12–0.77, p=0.027), higher education (OR 0.27, 95% CI 0.09–0.81, p=0.050), average financial status (OR 0.30, 95% CI 0.12–0.77, p=0.013), above-average financial status (OR 0.28, 95% CI 0.09–0.81, p=0.019), moderate physical activity outside leisure (OR 0.39, 95% CI 0.17–0.91, p=0.030), high physical activity outside leisure (OR 0.30, 95% CI 0.10–0.91, p=0.033), and drinking alcohol once/week or more (OR 0.22, 95% CI 0.09–0.79, p=0.017). Following a diet increased odds of mobility impairment (OR 2.38, 95% CI 1.18–4.76, p=0.015). Perceiving health as same as peers (OR 0.10, 95% CI 0.04–0.22, p<0.001) or better (OR 0.07, 95% CI 0.02–0.22, p<0.001) strongly reduced odds.
**Clinical Implications:** This study confirms that overweight and obesity are strong predictors of metabolic disease in Polish elderly, while higher education, better financial status, and physical activity are protective against mobility impairment. The finding that following a diet was associated with higher odds of both conditions likely reflects reverse causation (disease prompting dietary change). Notably, 73% of participants were overweight or obese, and risky dietary behaviors (e.g., low fluid intake, meal skipping) were common, especially among those with both conditions. The results underscore the need for public health strategies tailored to socio-demographic subgroups, including nutritional education and physical activity promotion for community-dwelling seniors. Limitations include the cross-sectional design (causality cannot be inferred), non-representative sampling (two regions, snowball method), and reliance on self-reported disease and BMI, which may underestimate obesity in older adults.