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Albumin, Apolipoprotein E‐ɛ4 and Cognitive Decline in Community‐Dwelling Chinese Older Adults
Author(s) -
Ng TzePin,
Niti Mathew,
Feng Lei,
Kua EeHeok,
Yap KengBee
Publication year - 2009
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2008.02086.x
Subject(s) - medicine , cognitive decline , odds ratio , dementia , confidence interval , population , cohort , depression (economics) , gerontology , body mass index , diabetes mellitus , cohort study , mini–mental state examination , demography , endocrinology , disease , environmental health , sociology , economics , macroeconomics
OBJECTIVES: To examine the association between serum albumin and cognitive impairment and decline in community‐living older adults. DESIGNS: Population‐based cohort study, followed up to 2 years; serum albumin, apolipoprotein E (APOE)‐ɛ4, and cognitive impairment measured at baseline and cognitive decline (≥2‐point drop in Mini‐Mental State Examination (MMSE) score). Odds ratios were controlled for age, sex, education, medical comorbidity, hypertension, diabetes mellitus, cardiac disease, stroke, smoking, alcohol drinking, depression, APOE‐ɛ4, nutritional status, body mass index, anemia, glomerular filtration rate, and baseline MMSE. SETTINGS: Local area whole population. PARTICIPANTS: One thousand six hundred sixty‐four Chinese older adults aged 55 and older. RESULTS: The mean age of the cohort was 66.0±7.3, 65% were women, mean serum albumin was 42.3±3.1 g/L, and mean MMSE score was 27.2±3.2. Lower albumin tertile was associated with greater risk of cognitive impairment in cross‐sectional analysis (low, odds ratio (OR)=2.30, 95% confidence interval (CI)=1.31–4.03); medium, OR=1.59, 95% CI=0.88–2.88) versus high ( P for trend=.002); and with cognitive decline in longitudinal analyses: low, OR=1.73, 95% CI=1.18–2.55; medium, OR=1.32, 95% CI=0.89–1.95, vs high ( P for trend=.004). In cognitively unimpaired respondents at baseline (MMSE≥24), similar associations with cognitive decline were observed ( P for trends <.002). APOE‐ɛ4 appeared to modify the association, due mainly to low rates of cognitive decline in subjects with the APOE‐ɛ4 allele and high albumin. CONCLUSION: Low albumin was an independent risk marker for cognitive decline in community‐living older adults.