Associations of the Geriatric Nutritional Risk Index(GNRI)and all-cause mortality risk in community-dwelling older adults
Objective The study aims to investigate the relationship between the Geriatric Nutritional Risk Index(GNRI)and the risk of all-cause mortality in older adults living in the community.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey.a community-based population cohort study utilized the Geriatric Nutritional Risk Index(GNRI),which was calculated based on height,weight,and serum albumin levels during baseline surveys conducted in 2012 and 2014.Participants were categorized into normal(GNRI＞98),mild malnutrition(92 ≤ GNRI≤ 98),and moderate/severe malnutrition(GNRI＜92)groups.Follow-up of all participants continued until 2018,during which data on death outcomes and survival time were gathered.The study employed Kaplan-Meier curves and Cox proportional hazards regression models to assess the relationship between GNRI levels and the risk of all-cause mortality.Results A total of 3,016 older adults were analyzed,with 1,296(42.97％)identified as having malnutrition.Over a follow-up period of 10,594.5 person-years,there were 1,280 deaths recorded.Adjusting for various factors such as sociodemographic characteristics,functional abilities,cognitive function,and chronic diseases,the mild malnutrition group showed a hazard ratio(CI)of 1.35(95％CI:1.18-1.56)compared to the normal group,while the moderate/severe malnutrition group had a HR of 1.85(95％CI:1.61-2.12)for all-cause mortality risk.The GNRI's area under the ROC curve for predicting death was 0.70(95％CI:0.61-0.77),with a sensitivity of 71.3％and specificity of 65.4％.Subgroup analysis revealed a more significant association between malnutrition and mortality risk in men compared to women(P-interaction=0.037).Conclusions The findings suggest a notable link between malnutrition levels and the risk of all-cause mortality,indicating that GNRI could be a valuable tool for predicting survival outcomes in this population.
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