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

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.