title: Change in serum albumin and subsequent decline in functional status in older persons.
abstract: OBJECTIVE
  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 (< or =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, a decrease 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.
authors.affiliation: Institute for Research in Extramural Medicine (EMGO Institute), VU University Medical Center, Amsterdam, The Netherlands. DJH.Deeg@vumc.nl
authors.forename: Bianca W M
authors.initials: BW
authors.lastname: Schalk
authors.forename: Marjolein
authors.initials: M
authors.lastname: Visser
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
authors.forename: Henk
authors.initials: H
authors.lastname: Baadenhuijsen
authors.forename: Lex M
authors.initials: LM
authors.lastname: Bouter
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000503:physiopathology*; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D011597:Psychomotor Performance; D012044:Regression Analysis; D012647:Self-Assessment; D012709:Serum Albumin / Q000378:metabolism*; D013223:Statistics as Topic; D011795:Surveys and Questionnaires
chemical_list: D012709:Serum Albumin