Association Between Geriatric Nutritional Risk Index and Frailty in Older Hospitalized Patients

Clin Interv Aging. 2021 Jun 28:16:1241-1249. doi: 10.2147/CIA.S313827. eCollection 2021.

Abstract

Objective: Previous studies have explored the association between malnutrition and frailty, but no study has investigated whether the Geriatric Nutritional Risk Index (GNRI), a simple and objective nutritional risk screening tool, is associated with the frailty of older adults. The study aimed to examine the relationship between nutrition-related risk, as assessed by the GNRI, and frailty among older hospitalized patients.

Methods: A cross-sectional study was conducted in the West China Hospital of Sichuan University with 740 patients aged ≥70 years between March 2016 and Jan 2017. Nutritional and frailty status was evaluated with the GNRI and FRAIL scale, respectively. The adjusted and unadjusted ordinal logistic regression analyses were used to examine the relationship between nutritional risk and frailty. The ability of GNRI in detecting frailty was assessed by receiver operating characteristic (ROC) curve analysis.

Results: The prevalence of low, moderate, and severe nutritional risk among frail patients were 30.1%, 27.6%, and 12.5%, respectively. Ordinal logistic regression analysis showed that malnutrition assessed by the GNRI had a significant association with frailty after adjustment of age, sex, polypharmacy, comorbidity, vision impairment, hearing impairment, cognitive impairment, and depression. In the ROC analysis, the area under the curve for GNRI identifying frailty was 0.698 (95% CI: 0.66-0.74; P<0.001), and the optimal cut-point value was 97.16 (sensitivity: 64.3%; specificity: 66.9%).

Conclusion: Nutrition-related risk screened by the GNRI was independently associated with frailty. The GNRI could be used as a simple tool in detecting nutritional risk and frailty status of older patients.

Keywords: Geriatric Nutritional Risk Index; frailty; malnutrition; older people.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • China
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Frailty / epidemiology*
  • Geriatric Assessment / methods
  • Hospitalization
  • Humans
  • Male
  • Malnutrition / diagnosis
  • Malnutrition / epidemiology*
  • Nutrition Assessment
  • Nutritional Status / physiology*
  • Prevalence
  • ROC Curve
  • Severity of Illness Index
  • Sex Factors

Grants and funding

This study was supported by Health Research of Cadres in Sichuan province (2019-106); the Chinese National Science & Technology Pillar Program (2020YFC2005600/02); Sichuan Science and Technology Program (2019YFS0277); National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University (Z20191003, Z2018B13); and the 1.3.5 Project for Disciplines of Excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (19HXFH012).