Hypoalbuminemia as a Risk Factor for Dementia in Older Adults with Mild Cognitive Impairment: A Retrospective 3-Year Follow-Up Study

Background and Objectives: Predicting the risk of progression from mild cognitive impairment (MCI) to dementia requires several clinical, radiological, and biochemical markers. Considering the possible neuroprotective features of albumin, this study evaluated whether hypoalbuminemia plays a role in the progression from MCI to dementia in older adults. Material and Methods: Older patients with MCI were divided into two groups according to their albumin levels: normoalbuminemia and hypoalbuminemia (albumin ≥ 4 g/dL and <4 g/dL, respectively). Demographics, biochemical characteristics, and comprehensive geriatric assessment parameters were collected retrospectively. During the three-year follow-up, the study focused on the progression from MCI to dementia, particularly its association with albumin levels. Results: Of the 650 participants, 233 patients were included in the hypoalbuminemia group and 417 were included in the control group. At baseline, the hypoalbuminemia group had higher mean age and Charlson Comorbidity Index (CCI) scores (p < 0.05 for each), whereas education levels, Montreal Cognitive Assessment (MoCA), and basic and instrumental daily living scores were lower (p < 0.05 for each). Among the 206 patients included in the final analysis, progression to dementia occurred in 33 of 69 patients in the hypoalbuminemia group and 30 of 137 patients in the normoalbuminemia group (47.8% vs. 21.9%; p < 0.001). After adjustment for age, sex, years of education, CCI, nutritional status and baseline MoCA score, hypoalbuminemia remained associated with higher odds of progression to dementia (OR, 2.61; 95% CI, 1.24–5.48; p = 0.012). Conclusions: This study demonstrated that hypoalbuminemia was associated with progression from MCI to dementia in older adults.