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 RB 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 RB 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.