title: Low body mass index and low serum albumin are predictive factors for short-term mortality in elderly Japanese requiring home care.
abstract: Japan has a rapidly growing elderly population requiring care. This study aimed to clarify risk factors for two-year mortality in such people. Subjects included 205 community-dwelling elderly people, who were approved for care in the 2003 Yamato Study, an epidemiologic study of individuals utilizing the long-term care service system. Demographic characteristics, Barthel index (measuring activities of daily living), grip strength, thigh muscle volume, psychological evaluation, and blood values including hemoglobin, serum albumin, and serum 25-hydroxyvitamin D levels were investigated at baseline. The average age of subjects was 83.6 (S.D., 8.0) years. Of the 205 subjects, 42 died during the follow-up period. Bivariate analysis showed that older age (p = 0.0015), lower weight (p = 0.0087), lower body mass index (BMI) (p = 0.0001), lower Barthel index (p = 0.0017), lower hemoglobin (p = 0.0180), and lower serum albumin (p = 0.0001) were associated with mortality, but that sex was not (p = 0.1248). Stepwise multiple logistic regression analysis showed that BMI < 17.1 kg/m(2) (adjusted OR = 4.0, p = 0.0007), age >or= 90 years (adjusted OR = 3.3, p = 0.0033), and lower serum albumin levels (adjusted OR = 0.86, p = 0.0007) were independently associated with mortality. We conclude that low BMI and low serum albumin are strong predictors of 2-year mortality in frail elderly individuals, and that nutritional risk should appropriately be evaluated for elderly people requiring home care.
authors.affiliation: Department of Nursing, Niigata University of Health and Welfare, Niigata, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Kitamura
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nishiwaki
authors.forename: Kimiko
authors.initials: K
authors.lastname: Ueno
authors.forename: Mariko
authors.initials: M
authors.lastname: Hasegawa
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D015992:Body Mass Index; D002423:Cause of Death; D005260:Female; D016330:Frail Elderly / Q000523:psychology / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D006304:Health Status; D006699:Home Care Services; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D009026:Mortality; D053580:Muscle Strength; D009752:Nutritional Status; D011788:Quality of Life; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*; D016019:Survival Analysis; D015996:Survival Rate
chemical_list: D012709:Serum Albumin