Supplementary Material

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Objective: In this retrospective study, we aimed to group the albumin concentrations at the time of hospitalization among elderly patients who were admitted for internal medical care. These concentrations were then used to clarify the relationship between physical function and activities of daily living.

Method: We included 1328 patients aged ≥ 65 years old who were hospitalized between December 2015 and April 2018. Data were collected on prehospital mobility, hand grip strength, balance, activities of daily living, and blood test results. Patients were assigned to low (< 2.5 mg/dL; 270 patients), mild (< 3.5 mg/dL; 796 patients), and normal (≥ 3.5 mg/dL; 262 patients) albumin groups.

Results: The low albumin group had worse outcomes in all evaluations. The risk of having poorer walking ability at discharge was significantly higher in the low albumin group than in the normal albumin group. Compared with the normal group, the OR for the low albumin group that was associated with a change in the level of assistance from independent to assisted walking was 1.7 (95% CI, 1.1–2.4; p < 0.01), whereas that for the mildly low albumin group was 1.3 (95% CI, 0.7–2.7; p = 0.33). The respective ORs for declining from independent walking to difficulty with walking were 2.4 (95% CI, 1.2–4.8; p < 0.01) and 2.1 (95% CI, 0.8–2.8; p = 0.25).

Conclusion: We conclude that a relationship exists between low admission albumin levels and poorer physical function at discharge.