The predictive factors of nutritional. decline in well-nourished functionally competent community-living elderly people were investigated, based on a two-year longitudinal study (1994-1996). The subjects were well-nourished, with a mean serum albumin level>4.0g/dl (men, 4.17g/dl; women, 4.25g/dl), and functionally competent elderly people (61 men and 194 women) aged 67 years and over (mean age, 72.3 years) living in a rural area (Nangai village, northern Japan). Potential confounding factors were simultaneously investigated at the baseline, and predictive factors for serum albumin decline (≥0.2g/dl) over the 2-year study were subjected to a multiple logistic regression analysis.
The respective average levels of serum albumin decline for the men and women were 0.08 and 0.10g/dl over the 2-year period. The decline of serum albumin was positively and independently associated with hospitalization within one year (3.16 relative risk (RR), 95% confidence interval (CI); 1.13-8.81, a fall within one year (2.21 RR, 95% CI; 0.89-5.45), a low level of leisure-time activity (never or sometimes, 2.17RR, 95% CI; 0.98-4.82), and limitation to high-level functional capacity (instrumental self-maintenance score<5; subscale of Tokyo Metropolitan Institute of Gerontology Index of Competence, 2.68 RR, 95% CI; 0.95-7.77). These four factors had a synergistic effect on the serum albumin decline; relative to the reference group with no one applicable factor, RR of the groups with at least one and two applicable factors were respectively 1.83 (95% CI; 0.76-4.42) and 7.12 (95% CI; 2.41-21.01), after adjusting for potential confounders.
The results suggest that physical inactivity accelerated the decline of nutritional status with advancing age in well-nourished functionally competent community-living elderly people.
