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

J Am Geriatr Soc. 2008 Mar;56(3):529-35. doi: 10.1111/j.1532-5415.2007.01549.x. Epub 2007 Dec 26.


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 (< or = 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Asian People / statistics & numerical data*
  • Cholesterol / blood*
  • Cohort Studies
  • Female
  • Health Status
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Mortality
  • Serum Albumin / metabolism*


  • Serum Albumin
  • Cholesterol