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Research Paper|Volume 12, Issue 2|pp 1104—1113

Body mass index and albumin levels are prognostic factors for long-term survival in elders with limited performance status

Kuan-Yu Lai1,2, Tai-Hsien Wu1,3, Chiu-Shong Liu1,2,4, Chih-Hsueh Lin1,2, Cheng-Chieh Lin1,2, Ming-May Lai1,2, Wen-Yuan Lin1,2,4
  • 1Department of Family Medicine, China Medical University Hospital, Taichung City, Taiwan
  • 2Department of Family Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
  • 3Department of Medical Research, China Medical University Hospital, Taichung City, Taiwan
  • 4Department of Social Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
Received: July 27, 2019Accepted: December 23, 2019Published: January 16, 2020
https://doi.org/10.18632/aging.102642

Copyright: © 2020 Lai et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Elderly long-term care facility residents typically have musculoskeletal conditions that may lead to long-term disability and increased mortality. Our main objective was to explore the relationship between body mass index (BMI), albumin levels, and mortality in elderly individuals with limited performance status. Among 182 participants (mean age, 78.8 years; 57% women), 11%, 64%, and 25% had serum albumin levels of <2.8, 2.8-3.5, and >3.5 g/dL, respectively. After multivariate adjustments, diastolic blood pressure >90 mmHg was associated with all-cause mortality [hazard ratio (HR) = 2.08, 95% confidence interval (CI) = 1.13-3.82; P = 0.018]. In addition, BMI <18.5 kg/m2 and albumin level <2.8 g/dL associated with higher mortality than BMI = 18.5-24 kg/m2 and albumin level > 3.5 g/dL (HR = 1.80, 95% CI = 1.11-2.94 and HR = 2.54, 95% CI 1.22-5.30, respectively; P = 0.018 and 0.013, respectively). Highest mortality was noted in participants with albumin levels <2.8 g/dL and BMIs <18.5 kg/m2 (HR = 6.12, 95% CI = 1.85-20.21, P = 0.003). Combined hypoalbuminemia (albumin level < 2.8 g/dL) and low BMI (<18.5 kg/m2) may be a useful prognostic indicator of high mortality risk in elderly individuals with limited performance status.