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Age and Ageing Advance Access originally published online on February 23, 2004
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Age and Ageing 2004; 33: 266-272
Age and Ageing Vol. 33 No. 3 © British Geriatrics Society 2004; all rights reserved

Research Paper

Lower levels of serum albumin and total cholesterol and future decline in functional performance in older persons: the Longitudinal Aging Study Amsterdam

Bianca W. M. Schalk, Marjolein Visser, Dorly J. H. Deeg and Lex M. Bouter

Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam, The Netherlands

Address correspondence to: B. W. M. Schalk, EMGO Institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. Fax: (+31) 20 444 6775. Email: bwm.schalk{at}vumc.nl

Abstract

Background: both serum albumin and total cholesterol are potential markers of frailty. A decline in functional status is one of the key components of frailty.

Objective: the aim of this study was to investigate the association of serum albumin and total cholesterol, separately and combined, with future decline in functional performance.

Design: the Longitudinal Aging Study Amsterdam, an ongoing population-based longitudinal study, started in 1992/1993 with a follow-up every 3 years.

Participants: 1,064 men and women aged 55–85 years with complete data on serum albumin and total cholesterol at baseline, and functional performance at baseline and 3-year follow-up.

Measurements: at baseline, serum albumin and total cholesterol were measured. At baseline and 3 years later, decline in functional status was measured with three performance tests (chair stand, 3-metre walk, putting on and taking off a cardigan). Associations were adjusted for age, life-style and health-related factors.

Results: albumin concentration was not associated with decline in functional performance in men and women. Women with lower serum total cholesterol concentration (<=5.2 mmol/l) were more likely to decline in functional status compared to women with higher serum total cholesterol concentration (reference; OR = 2.50; 95% CI 1.07–5.84). Men with lower serum albumin (<=43 g/l) and lower serum total cholesterol concentration were three times more likely to decline in functional performance compared to men with higher levels (OR = 3.00; 95% CI 1.00–8.97). In women, a similar trend was found (OR = 1.73; 95% CI 0.34–8.94), although not statistically significant.

Conclusions: a combination of low albumin and low cholesterol levels may increase the risk of future functional decline.

Keywords: serum albumin, serum cholesterol, functional status, performance test, frailty, elderly, longitudinal

Received November 12, 2002; Revision received November 25, 2003. accepted in revised form November 25, 2003.


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