Chronic Status of Serum Albumin and Cognitive Function: A Retrospective Cohort Study

Abstract

Previous studies have found an association between serum albumin levels and cognitive function. However, the results of this association are inconsistent, and the effect of Apolipoprotein E (APOE) on the association is less clear. Using retrospective cohort data (2008–2020), we investigated whether chronic serum albumin was associated with cognitive performance in older adults. We further assessed how the APOE genotype modifies its relevance. A total of 2396 Korean veterans and their families who were aged 65 years or older in 2008 and who had both data of serum albumin and cognitive performance (assessed by the Mini-Mental State Examination, MMSE) were included for the current study. The serum albumin levels were divided into four groups by quartiles: Group 1 (<4.0 g/dL), Group 2 (4.0–4.19 g/dL), Group 3 (4.2–4.49 g/dL), and Group 4 (≥4.5 g/dL). APOE ε4 carriers were defined as the presence of at least one ε4 allele (ε2/4, ε3/4, ε4/4). After adjusting for age, sex, and medical conditions, serum albumin levels (assessed by the median serum albumin levels during the study period) were significantly associated with increases in the median MMSE scores (beta = 3.30, p < 0.0001). Compared with the lowest median albumin category (Group 1), the beta coefficients for the median MMSE score were significantly and gradually increased in Group 2 (beta = 2.80, p < 0.0001), Group 3 (beta = 3.71, p < 0.0001), and Group 4 (beta = 4.01, p < 0.0001), respectively. In the analysis of repeated albumin measures, similar patterns were observed in cognitive function. All regression coefficients were greater in ε4 carriers than in non-carriers. Our findings suggested that sustained lower serum albumin levels were associated with lower MMSE scores. This observation may be modified by APOE polymorphisms.

The factors associated with cognitive function among community-dwelling older adults in Taiwan

“…Our results indicated that participants with a higher albumin level had a lower risk of cognitive impairment. Lower albumin levels have been reported to be correlated with poor cognitive performance in older adults [55][56][57]. In a previous study done in Japan [58], a positive association between the serum albumin/globulin ratio (A/G ratio) and cognitive function was found in 70-year-old and 80-year-old participants.…”

Association of Nutritional Risk With Gait Function and Activities of Daily Living in Older Adult Patients With Hip Fractures

“…However, regarding the relationship between nutritional risk and cognitive function, the intricate mechanisms underlying the effect of malnutrition on cognitive function have not been fully elucidated. Nevertheless, clinical evidence has shown many instances linking malnutrition to cognitive function [ 34 , 35 ]. Furthermore, malnutrition in patients with hip fractures results in a more pronounced decline in ADLs when combined with cognitive impairment [ 12 ].…”

Systems Age: A single blood methylation test to quantify aging heterogeneity across 11 physiological systems

“…The Liver and Blood scores showed strong correlations, potentially reflecting the liver's blood filtration function and production of blood products. Both Liver and Blood were highly correlated with Brain, potentially reflecting known contributions of anemia and altered levels of liver products to brain aging [46][47][48][49] . Metabolic, Inflammation, and Kidney were highly correlated, reflecting numerous links between metabolism and inflammation 50 as well as the inclusion of IL-6 and CRP in both systems, and the contributions of both to kidney aging 51,52 .…”