One in six people over 75 are likely to have at least one abnormal liver test and those that have two or more are twice as likely to die from cancer and 17 times more likely to die from liver disease, according to research in the August issue of Alimentary Pharmacology and Therapeutics.
UK researchers studied 13,276 patients who were registered with 53 family doctors and agreed to an in-depth health assessment. Patients were drawn at random from the general population and those who were terminally ill or living in nursing homes were excluded.
"The aim of our study was to see how prevalent abnormal liver tests were in a random sample of people aged 75 plus and examine the association between positive results and deaths from all causes and specific causes" says lead author Dr Kate Fleming from the University of Nottingham.
"Previous studies from The Netherlands, South Korea, the USA and Scotland produced conflicting results and none particularly focused on older people."
The study covered liver tests for abnormal levels of asparate transaminase (AST), alkaline phosphatase (ALP) and bilirubin, with patients being followed up for an average of just over seven years. The elderly patients with the abnormal liver tests were compared with patients with normal liver tests.
"A wide range of health problems can lead to elevated levels of enzymes in the liver, not just liver disease" explains Dr Fleming. "These can include heart disease, bone disorders, kidney disease and striated muscle disorders."
Key findings of the study included:
"Our study shows that abnormal liver tests are common in elderly people, but are only associated with a modest increase in deaths from all causes, with specific reference to liver disease, cancer, heart disease and respiratory disease" says Dr Fleming.
"There is currently no evidence that a single abnormal and isolated measurement of AST, ALP or bilirubin leads to an overwhelming increase in death rates. Given that, the current clinical practice of only referring and actively investigating patients with multiple or persistent abnormalities should be continued.
"Older people represent an increasingly large group of healthcare users in the UK and we hope that this research will provide useful information in an area that has previously suffered from lack of research."
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