0
ARTICLE |

Serum Albumin Level and Physical Disability as Predictors of Mortality in Older Persons

Maria-Chiara Corti, MD, MHS; Jack M. Guralnik, MD, PhD; Marcel E. Salive, MD, MPH; John D. Sorkin, MD
JAMA. 1994;272(13):1036-1042. doi:10.1001/jama.1994.03520130074036.
Text Size: A A A
Published online

Objectives.  —To study the relationship between serum albumin level and all-cause mortality in an elderly population and to evaluate the role of albumin level in combination with physical disability status in predicting mortality.

Design.  —Cohort study with a mean follow-up of 3.7 years.

Setting.  —Three communities: East Boston, Mass, New Haven, Conn, and Iowa and Washington counties, Iowa.

Subjects.  —A total of 1486 men and 2630 women aged 71 years and older who consented to have blood drawn.

Results.  —During follow-up, 447 men and 488 women died. In both sexes, there was a graded increase in mortality rate with decreasing albumin level. After adjusting for age, race, education, chronic conditions, and disability status, hypoalbuminemia (<35 g/L) was associated with a significantly increased risk of mortality in comparison with the reference group (ie, those with albumin levels greater than 43 g/L) (men: relative risk [RR], 1.9; 95% confidence interval [CI], 1.1 to 3.1; women: RR, 3.7; 95% CI, 2.5 to 5.5). Among those with albumin levels in the range usually considered normal (35 g/L to 50 g/L), there was a graded increase in mortality risk from the highest normal to the lowest normal groups. For women, results were similar in separate analyses that considered deaths occurring during the first year and 1 year or more after baseline, while for men the relationship decreased after 1 year. Lower albumin level was associated with an elevated risk of mortality for all categories of causes of death. A 15-level measure that characterized participants according to albumin level and disability status demonstrated that mortality increased with decreasing albumin level and increasing disability level.

Conclusions.  —Serum albumin level is an independent risk factor for all-cause mortality in older persons. A combined measure of albumin and disability reveals a strong gradient in mortality risk and may serve as a simple but useful index of frailty that can identify a high-risk group of older men and women who could be targeted for preventive and treatment efforts.(JAMA. 1994;272:1036-1042)

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

References

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();