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Age and Ageing Advance Access published online on February 23, 2004
Age and Ageing, doi:10.1093/ageing/afh073
© 2004 by British Geriatrics Society
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Received November 12, 2002
Accepted November 25, 2003

Article

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 1*, Marjolein Visser 1, Dorly J. H. Deeg 1, Lex M. Bouter 1

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

* To whom correspondence should be addressed. E-mail: 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


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