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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

Authors

  • Tomonori Okamura MD,

    1. From the *Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, JapanDepartment of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, JapanDepartment of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan§Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VirginiaThe First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Tokyo, Japan.
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  • Takehito Hayakawa PhD,

    1. From the *Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, JapanDepartment of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, JapanDepartment of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan§Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VirginiaThe First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Tokyo, Japan.
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  • Atsushi Hozawa MD,

    1. From the *Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, JapanDepartment of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, JapanDepartment of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan§Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VirginiaThe First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Tokyo, Japan.
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  • Takashi Kadowaki MD,

    1. From the *Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, JapanDepartment of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, JapanDepartment of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan§Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VirginiaThe First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Tokyo, Japan.
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  • Yoshitaka Murakami PhD,

    1. From the *Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, JapanDepartment of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, JapanDepartment of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan§Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VirginiaThe First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Tokyo, Japan.
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  • Yoshikuni Kita PhD,

    1. From the *Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, JapanDepartment of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, JapanDepartment of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan§Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VirginiaThe First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Tokyo, Japan.
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  • Robert D. Abbott PhD,

    1. From the *Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, JapanDepartment of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, JapanDepartment of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan§Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VirginiaThe First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Tokyo, Japan.
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  • Akira Okayama MD,

    1. From the *Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, JapanDepartment of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, JapanDepartment of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan§Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VirginiaThe First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Tokyo, Japan.
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  • Hirotsugu Ueshima MD,

    1. From the *Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, JapanDepartment of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, JapanDepartment of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan§Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VirginiaThe First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Tokyo, Japan.
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  • for the NIPPON DATA80 Research Group

    1. From the *Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, JapanDepartment of Preventive Cardiology, National Cardiovascular Center, Suita, Osaka, JapanDepartment of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima, Japan§Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, VirginiaThe First Institute for Health Promotion and Health Care, Japanese Anti-Tuberculosis Association, Tokyo, Japan.
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  • Members of the NIPPON DATA80 Research Group are listed in Okamura et al.18

Address correspondence to Tomonori Okamura, MD, Department of Health Science, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City, Shiga 520-2192, Japan. E-mail: tokamura@belle.shiga-med.ac.jp

Abstract

OBJECTIVES: 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.

DESIGN: Population-based cohort study.

SETTING: National Integrated Project for Prospective Observation of Non-Communicable Disease and Its Trends in the Aged, 1980.

PARTICIPANTS: One thousand eight hundred forty-four Japanese individuals aged 60 to 74 randomly selected throughout Japan and followed for 12.4 years.

MEASUREMENTS: 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 (≤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.

CONCLUSION: In the Japanese general population, low-normal serum albumin and TC levels are associated with loss of activity during old age, especially for women.

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