Vol.:(0123456789) 1 3
Aging Clinical and Experimental Research
https://doi.org/10.1007/s40520-018-0892-2
ORIGINAL ARTICLE
Geriatric nutritional risk index as a simple tool for assessment
of malnutrition among geriatrics in Northwest of Iran: comparison
with mini nutritional assessment
Maryam Saghaf‑Asl
1
· Elnaz Vaghef‑Mehrabany
1
· Nahid Karamzad
2
· Lida Daeiefarshbaf
1
· Parinaz Kalejahi
1
·
Mohammad Asghari‑Jafarabadi
3
Received: 23 August 2017 / Accepted: 3 January 2018
© Springer International Publishing AG, part of Springer Nature 2018
Abstract
Background Older people are more likely to develop nutritional problems and timely diagnosis of malnutrition is crucial to
prevent hazardous consequences following poor nutrition.
Aims To evaluate the efcacy of Geriatric Nutritional Risk Index (GNRI) to assess nutritional status among non-hospitalized
elderly, compared to mini nutritional assessment (MNA) among Iranian seniors.
Methods One hundred and sixty-four subjects, aged ≥ 65 years old were recruited to our cross-sectional study from various
districts of Tabriz (Tabriz, Iran). Anthropometric and biochemical measurements were performed, short- and long-form
MNAs and GNRI were assessed in our study subjects. Sensitivity, specifcity and predictive values of the three indices,
agreement between them, and their correlation with anthropometric and biochemical parameters were evaluated. Receiver-
operating characteristic (ROC) curve analysis was performed to determine the optimal cut-of point for GNRI in our study
population.
Results GNRI had lower sensitivity (50, 57%), but optimal specifcity (94, 93%) and lower negative predictive value (NPV;
68, 71%) compared to MNA-LF and MNA-SF, respectively. We found a moderate agreement between GNRI and MNA-SF
(K = 0.52) and MNA-LF (K = 0.46) scores. Signifcant correlations were observed between re-categorized MNAs as well
as GNRI scores, and age, weight, MAC, CC, WC, albumin, and pre-albumin. The cut-of point of 110.33 was obtained for
GNRI, according to the ROC curve.
Conclusions Although GNRI may not be an efcient tool for screening malnutrition due to its lower sensitivity, it is mod-
erately correlated with MNAs and also more useful when limited funding needs to target the truly malnourished seniors.
Keywords Elderly · Geriatric Nutritional Risk Index (GNRI) · Mini nutritional assessment (MNA) · Sensitivity ·
Specifcity
Introduction
Aging has become a global concern due to its rapid growth;
it is predicted that the number of the elderly will triple by
the year 2050 compared to 2000 [1]. Iran is not an exception
from this graying process of the world, and is estimated to
experience an “Aging Tsunami” by 2046, its senior popula-
tion increasing from the current 8.2–22% in that year [2].
This aging population with particular requirements demands
special social infrastructures and welfare [3]; improved
healthcare systems including appropriate nutritional assess-
ments, which can lead to prompt and relevant interventions,
are amongst the most important factors to take into account,
in this regard.
* Elnaz Vaghef-Mehrabany
elnaz.vaghef@gmail.com; vaghefe@tbzmed.ac.ir
1
Department of Biochemistry and Diet Therapy, Talented
Students Center, School of Nutrition and Food Sciences,
Tabriz University of Medical Sciences, Tabriz, Iran
2
Maragheh University of Medical Sciences, Maragheh, Iran
3
Department of Statistics and Epidemiology, Faculty
of health, Road Trafc Injury Research Center, Tabriz
University of Medical Sciences, Tabriz 5166614711, Iran