title: Lower levels of serum albumin and total cholesterol associated with decline in activities of daily living and excess mortality in a 12-year cohort study of elderly Japanese.
abstract: OBJECTIVE
  To examine the association between levels of serum albumin and total cholesterol (TC) and risk of subsequent mortality and future decline in activities of daily living (ADLs) in elderly people.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  National Integrated Project for Prospective Observation of Non-Communicable Disease and Its Trends in the Aged, 1980.
  
  
  METHODS
  One thousand eight hundred forty-four Japanese individuals aged 60 to 74 randomly selected throughout Japan and followed for 12.4 years.
  
  
  METHODS
  Decline in ADLs and mortality.
  
  
  RESULTS
  After adjusting for other covariates, the multivariable odds ratios (ORs) of impaired ADLs were highest in the lowest albumin quartile (< or = 40 g/L) for women. The multivariable OR of having a composite outcome of death or impaired ADL for the lowest albumin quartile compared with the highest was 1.56 (95% confidence interval (CI)=1.94-2.57) for men and 3.06 (95% CI=1.89-4.95) for women. Serum albumin was significantly and inversely associated with a composite outcome of death or impaired ADLs in the group below the median of TC in both sexes (multivariable OR for 1-g/L increase in serum albumin=0.88 for men (95% CI=0.79-0.97) and 0.79 for women (95% CI=0.72-0.87)), which was not significantly associated in the group with TC at or above the median.
  
  
  CONCLUSIONS
  In the Japanese general population, low-normal serum albumin and TC levels are associated with loss of activity during old age, especially for women.
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, Japan. tokamura@belle.shiga-med.ac.jp
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Takehito
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hozawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Kadowaki
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Murakami
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Kita
authors.forename: Robert D
authors.initials: RD
authors.lastname: Abbott
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D002784:Cholesterol / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012709:Serum Albumin / Q000378:metabolism*
chemical_list: D012709:Serum Albumin; D002784:Cholesterol