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Change in serum albumin and subsequent decline in functional status in older persons

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Abstract

Background and aims: This study examines whether a three-year change in serum albumin concentration is associated with subsequent decline in functional status in older persons. Methods: A total of 588 participants from the Longitudinal Aging Study Amsterdam aged 65–85 years were followed for six years. The three-year change in serum albumin was classified in four groups: chronic low (≤43 g/L at both time points), decrease (decrease of 2.4% or more) from normal to low, decrease but still normal, and stable normal albumin (reference group). During the subsequent three years, absolute change and a decline of one standard deviation or more (termed substantial decline) in functional status was assessed. Functional status was measured in two ways: using performance tests and self-reported functional ability. Results: Substantial decline in functional performance and functional ability was observed in 243 persons (41.3%) and 133 persons (22.6%), respectively. After adjustment for baseline functional status and potential confounders, chronic low albumin and a decrease from normal to low albumin were associated with a greater absolute decline in functional performance and in self-reported functional ability. Using the outcome substantial decline in functional status, only decrease to low serum albumin was associated with decline in functional ability [odds ratio (OR)=1.97; one-sided 95% Confidence Limit (CL)=1.09]. Conclusions: This study indicates that chronic low serum albumin is a determinant of decline in functional status. However, adecrease in serum albumin from normal to low levels but within the normal range was a stronger determinant of future decline in functional status. Change in serum albumin level within the normal range measured between two points in time may be used as a general marker of future functional decline.

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Authors and Affiliations

  1. Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands

    Bianca W. M. Schalk MSc, Marjolein Visser, Brenda W. J. H. Penninx, Lex M. Bouter & Dorly J. H. Deeg

  2. Sticht Center on Aging, Wake Forest University Health Sciences, Winston-Salem, USA

    Brenda W. J. H. Penninx

  3. Dutch Foundation for Quality Assessment in Clinical Laboratories (SKZL), University Medical Center Nijmegen, Nijmegen, The Netherlands

    Henk Baadenhuijsen

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  1. Bianca W. M. Schalk MSc
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  2. Marjolein Visser
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  3. Brenda W. J. H. Penninx
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  4. Henk Baadenhuijsen
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  6. Dorly J. H. Deeg
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Schalk, B.W.M., Visser, M., Penninx, B.W.J.H. et al. Change in serum albumin and subsequent decline in functional status in older persons. Aging Clin Exp Res 17, 297–305 (2005). https://doi.org/10.1007/BF03324614

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  • DOI: https://doi.org/10.1007/BF03324614

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