The predictive value of combined hypoalbuminemia and hypocholesterolemia in high functioning community-dwelling older persons: MacArthur studies of successful aging

OBJECTIVES: To examine the effect of simultaneous hypoalbuminemia and hypocholesterolemia levels on 3- and 7-year rates of mortality and decline in functional status. METHODS: In this cohort study, 937 community-based persons aged 70 to 79 years in 1988, who had high baseline physical and cognitive functioning, were classified into four groups: Group 1 (low albumin, low cholesterol), Group 2 (low albumin, normal cholesterol), Group 3 (normal albumin, low cholesterol) and Group 4 (normal albumin, normal cholesterol) using baseline blood values. Crude and multiply adjusted rates of (1) mortality (2) decline in Rosow-Breslau (RB) functional status, and (3) mortality or decline in RE functional status in 1991 and 1995 were calculated. RESULTS: Group 1 subjects had multiply adjusted relative risks (ARR) of 3.62 and 3.53 for 3-and 7-year mortality compared with Group 4. Group 1 subjects had ARRs of 3.82, 3.02, and 2.67 of 3-year mortality or decline in RE activity scale when compared with Groups 4, 2, and 3, respectively. CONCLUSIONS: Concomitant low serum cholesterol and albumin levels may identify high functioning older persons who are at increased risk of subsequent mortality and functional decline.