Abstract
Objectives
Albumin and hemoglobin are viewed as markers of nutritional and inflammatory status. This study examined the associations of serum albumin and hemoglobin with physical function in communityliving older adults.
Design
Population-based cross-sectional and longitudinal study.
Setting
The Singapore Longitudinal Aging Studies (SLAS), a community-based study in urban Singapore.
Participants
2762 older adults aged 55 and above assessed at baseline, and 1829 at follow up 1–2 years later.
Measurements
Serum albumin and hemoglobin, Performance Oriented Mobility Assessment (POMA), knee extension strength at baseline, and Instrumental Activities of Daily Living (IADL) at baseline and follow up.
Results
In crosssectional multivariate analyses that adjusted for haemoglobin and other confounders, albumin showed a significant linear association (p<0.001) with POMA balance score (b=0.06, SE=0.02) and knee extension strength (b=0.70, SE=0.10). Independently of albumin, hemoglobin also showed a significant linear association with POMA balance score (b=0.09, SE=0.04). In longitudinal analyses, albumin was significantly associated with IADL decline (IADL total score drop>=1 during follow-up), OR= 0.92 (0.87–0.97), p=<0.01.
Conclusion
The findings suggest that low levels of albumin and hemoglobin are potentially useful risk markers of physical functional decline in older adults. Further research should investigate whether improvements in the levels of albumin and hemoglobin alter the level of functional disability and risk of functional decline.
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References
Stuck AE, Walthert JM, Nikolaus T et al. Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med 1999;48:445–469.
Okamura T, Hayakawa T, Hozawa A, et al. 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. J Am Geriatr Soc 2008;56:529–535.
Schalk BW, Deeg DJ, Penninx BW et al. Serum albumin and muscle strength: a longitudinal study in older men and women. J Am Geriatr Soc 2005;53:1331–1338.
Reuben DB, Cheh AI, Harris TB, et al. Peripheral blood markers of inflammation predict mortality and functional decline in high-functioning community-dwelling older persons. J Am Geriatr Soc 2002;50:638–644.
Schalk BWM, Visser M, Deeg DJH et al. Lower levels of serum albumin and total cholesterol and future decline in functional performance in older persons: the Longitudinal Aging Study Amsterdam. Age Ageing 2004;33:266–272.
Eisenstaedt R, Penninx BW, Woodman RC. Anemia in the elderly: current understanding and emerging concepts. Blood Rev 2006;20:213–226.
Chaves PH, Ashar B, Guralnik JM et al. Looking at the relationship between hemoglobin concentration and prevalent mobility difficulty in older women. Should the criteria currently used to define anemia in older people be reevaluated? J Am Geriatr Soc 2002;50:1257–1264.
Denny SD, Kuchibhatla MN, Cohen HJ. Impact of anemia on mortality, cognition, and function in community-dwelling elderly. Am J Med 2006;119:327–334.
Penninx BW, Pahor M, Cesari M, et al. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc 2004;52:719–724.
Penninx BW, Guralnik JM, Onder G et al. Wallace RB, Pahor M. Anemia and decline in physical performance among older persons. Am J Med 2003;115:104–110.
Visser M, Kritchevsky SB, Newman AB, et al. Lower serum albumin concentration and change in muscle mass: the Health, Aging and Body Composition Study. Am J Clin Nutr 2005;82:531–537.
Goldwasser P, Feldman J. Association of serum albumin and mortality risk. J Clin Epidemiol. 1997 Jun;50(6):693–703.
Means RT Jr. Pathogenesis of the anemia of chronic disease: a cytokine-mediated anemia. Stem Cells 1995;13:32–37.
Feng L, Ng TP, Chuah L et al. Homocysteine, folate, and vitamin B-12 and cognitive performance in older Chinese adults: findings from the Singapore Longitudinal Ageing Study. Am J Clin Nutr 2006;84:1506–1512.
Ho RC, Niti M, Yap KB et al.. Metabolic syndrome and cognitive decline in Chinese older adults: results from the singapore longitudinal ageing studies. Am J Geriatr Psychiatry 2008;16:519–522.
Niti M, Ng TP, Kua EH et al. Depression and chronic medical illnesses in Asian older adults: the role of subjective health and functional status. International Journal of Geriatric Psychiatry 2007;22:1087–1094.
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179–186.
Niti M, Ng TP, Chiam PC et al. Item response bias was present in Instrumental Activity of Daily Living Scale in Asian older adults. J Clin Epidemiol, 2007;60:366–374
Niti M, Ng TP, Chiam PC et al. Physical and cognitive domains of the instrumental activities of daily living: validation in a multiethnic population of Asian older adults. J Gerontol Biol Med Sci, 2006; Vol. 61 A:726–735
Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986;34:119–126.
Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther 2003;83:237–252.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
Ng TP, Niti M, Chiam PC et al. Ethnic and Educational Differences in Cognitive Test Performance on Mini-Mental State Examination in Asians. Am. J. Geriatr. Psychiatry 2007;15:130–139.
Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1982;17:37–49.
Yesavage JA. Geriatric Depression Scale. Psychopharmacol Bull 1988;24:709–711.
Lim PP, Ng LL, Chiam PC et al. Validation and comparison of three brief depression scales in an elderly Chinese population. Int J Geriatr Psychiatry 2000;15:824–830.
Broekman BF, Nyunt SZ, Niti M, et al. Differential item functioning of the Geriatric Depression Scale in an Asian population. J Affect Disord 2008;108:285–290.
Glymour MM, Weuve J, Berkman LF, Kawachi I, Robins JM. When is baseline adjustment useful in analyses of change? An example with education and cognitive change. Am J Epidemiol. 2005 Aug 1;162(3):267–278.
Ferrucci L, Harris TB, Guralnik JM, et al. Serum IL-6 level and the development of disability in older persons. J Am Geriatr Soc 1999;47:639–646.
Tinetti ME, Williams CS, Gill TM. Health, functional, and psychological outcomes among older persons with chronic dizziness. J Am Geriatr Soc 2000;48:417–421.
Dodd SL, Powers SK, Brooks E et al. Effects of reduced O2 delivery with anemia, hypoxia, or ischemia on peak VO2 and force in skeletal muscle. J Appl Physiol 1993;74:186–191.
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Aung, K.C.Y., Feng, L., Yap, K.B. et al. Serum albumin and hemoglobin are associated with physical function in community-living older persons in Singapore. J Nutr Health Aging 15, 877–882 (2011). https://doi.org/10.1007/s12603-011-0120-7
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DOI: https://doi.org/10.1007/s12603-011-0120-7