Abstract
BackgroundLow serum albumin levels are associated with aging and medical conditions such as cancer, liver dysfunction, inflammation, and malnutrition and might be an independent predictor of long-term mortality in healthy older populations. We tested the hypothesis that economic status is associated with serum albumin levels and explained by nutritional and health status in Japanese older adults.DesignWe performed a cross-sectional analysis using data from the Japan Gerontological Evaluation study (JAGES). The study participants were 6528 functionally independent residents (3189 men and 3339 women) aged ≥65 years living in four municipalities in Aichi prefecture. We used household income as an indicator of economic status. Multiple linear regression was used to compare serum albumin levels in relation to household income, which was classified as low, middle, and high. Additionally, mediation by nutritional and health-related factors was analyzed in multivariable models.ResultsWith the middle-income group as reference, participants with low incomes had a significantly lower serum albumin level, even after adjustment for sex, age, residential area, education, marital status, and household structure. The estimated mean difference was −0.17 g/L (95% confidence interval, −0.33 to −0.01 g/L). The relation between serum albumin level and low income became statistically insignificant when “body mass index”, “consumption of meat or fish”, “self-rated health”, “presence of medical conditions”, “hyperlipidemia”, or “respiratory disease “was included in the model.ConclusionSerum albumin levels were lower in Japanese older adults with low economic status. The decrease in albumin levels appears to be mediated by nutrition and health-related factors with low household incomes. Future studies are needed to reveal the existence of other pathways.
Highlights
Japan is a rapidly aging society and has one of the oldest populations in the world; 25% of Japanese are older than 65 years
Serum albumin levels were lower in Japanese older adults with low economic status
Using baseline data from a cohort study, we investigated the relationship between serum albumin level and economic status of Japanese older adults and assessed whether health and nutrition status mediated this relationship
Summary
Japan is a rapidly aging society and has one of the oldest populations in the world; 25% of Japanese are older than 65 years. A government report noted that healthy life expectancy at birth is 71.2 years for men and 74.2 years for women, a 10-year difference from life expectancy values [2]. To extend the healthy life of older adults, identifying and addressing risk factors for health problems will be required [3,4,5]. 1.7% of Japanese receive government welfare support, and 45% of the recipients are older adults[10]. Low serum albumin levels are associated with aging and medical conditions such as cancer, liver dysfunction, inflammation, and malnutrition and might be an independent predictor of long-term mortality in healthy older populations. We tested the hypothesis that economic status is associated with serum albumin levels and explained by nutritional and health status in Japanese older adults
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