Low Serum Albumin Levels Increase Mortality Risk in Elderly: Lancet Study

A recent study from the Moli-sani study cohort revealed that low levels of serum albumin are significantly associated with increased mortality risk among the individuals over 65 years. The findings published in the Lancet eClinicalMedicine illuminate the importance of serum albumin as a potential biomarker for mortality in the context of cancer and vascular diseases.

This comprehensive study analyzed data from a population-based cohort that comprised a total of 17,930 individuals of 35 years and above. Over a median follow-up period of 13.1 years this research meticulously examined the relationship between serum albumin levels and cause-specific mortality using competing-risk survival analysis.

Hypoalbuminemia (serum albumin levels of 35 g/L or lower) was found in 2.3% of the study participants. Among the 1428 recorded deaths, 574 were attributed to cancer and 464 to vascular causes. The analysis revealed that hypoalbuminemia was independently associated with mortality when compared to the individuals with serum albumin levels above 40 g/L.

A decrease of 1 standard deviation in serum albumin levels corresponded to a higher risk of total mortality, vascular mortality and cancer mortality. Further stratification by age demonstrated that hypoalbuminemia was linked to mortality in individuals aged 65 and above. The elderly individuals with serum albumin levels ≤35 g/L had a significantly higher risk of total, cancer and vascular mortality when compared to their younger counterparts.

These findings underline the critical role of serum albumin as a prognostic marker for mortality risk among the older adults. Serum albumin plays a crucial role in maintaining the oncotic pressure and transporting various substances in the blood. The decline has been associated with inflammation, malnutrition and chronic diseases, all of which are known risk factors for mortality.

This study suggest that monitoring serum albumin levels could help identify individuals at elevated risk of mortality by allowing for targeted interventions and preventive measures.  These outcomes may potentially reduce the risk of death from cancer and vascular diseases by identifying and addressing hypoalbuminemia in older adults. Overall, this study provides strong evidence of the association between low serum albumin levels and increased mortality risk among the elderly individuals.

Reference:

Di Castelnuovo, A., Bonaccio, M., Costanzo, S., De Curtis, A., Magnacca, S., Persichillo, M., Panzera, T., Bracone, F., Pignatelli, P., Carnevale, R., Cerletti, C., Donati, M. B., de Gaetano, G., Iacoviello, L., Violi, F., Iacoviello, L., de Gaetano, G., Donati, M. B., Cerletti, C., … Bonanni, A. (2024). The association between hypoalbuminemia and risk of death due to cancer and vascular disease in individuals aged 65 years and older: findings from the prospective Moli-sani cohort study. In eClinicalMedicine (p. 102627). Elsevier BV. https://doi.org/10.1016/j.eclinm.2024.102627