Objectives: To describe longitudinal relationships of metabolic syndrome (MetS) to cognitive decline and functional disability in a sample of older non-institutionalized men. Methods: data from 1991 to 2000 of the Italian cohorts of the Finland, Italy, the Netherlands, Elderly (FINE) study, were used. Global cognitive function and functional disability, defined as limitations in mobility, basic (ADLs) and instrumental activities of daily living (IADLs) were screened in 1991 and 2000. MetS was defined according to the NCEP ATP-III criteria. Results: The study sample consisted of 195 men, baseline age 76.1 +/- 3.1 years. Baseline MetS was prospectively associated with greater 10-year cognitive and functional decline in ADLs and IADLs. After multiple adjustment including age, education, marital status, ApoE epsilon 4 allele, cerebrovascular disease and initial cognitive and depressive status, MetS predicted cognitive decline (B = - 1.684, 95% CI = - 2.202 to - 1.167, p < 0.001) and risk of IADLs (OR = 1.09, 95% CI = 1.01-1.20, p = 0.048) and ADLs disability (OR = 1.35, 95% CI = 1.12-1.62, p < 0.001). Interestingly, such associations were not attributable to individual altered components of MetS nor to their sum. Incident disability in ADLs and IADLs were not explained by parallel decline in cognitive function. Conclusions: MetS as an entity was associated with accelerated cognitive and functional decline in a population-based sample of very old men. (C) 2016 Elsevier Ireland Ltd. All rights reserved.