The role of nutritional risk indexes in predicting physical frailty and its progression in community-dwelling older adults

Malnutrition and frailty are common and closely related in older adults. The aim of this study is to investigate the longitudinal associations on the nutritional risk indexes and frailty onset in Healthy Aging Longitudinal Study in Taiwan. This study analyzed 5,348 community-dwelling adults aged ≥55 years old who were recruited from 2009 to 2013 and followed up from 2013 to 2020. Nutritional risk was assessed using Geriatric Nutrition Risk Index (GNRI) and Prognostic Nutritional Index (PNI) at baseline. Poor nutrition was defined as GNRI ≤ 98 or PNI < 50. Frailty was assessed with Fried’s criteria. Mortality was confirmed via data linkage with the Death Certificate database. Estimates of associations were by odds ratios (ORs) and hazard ratios (HRs) and their 95% confidence intervals (95% CI) and adjusted for major confounders. The prevalence of low GNRI and low PNI were 3.9% and 22.2%, respectively, in this community-dwelling middle-aged and older adults. Both low GNRI and low PNI were associated with frailty status (OR = 10.3, 95% CI = 3.59–29.4, p trend < 0.01 for the GNRI and OR = 5.57, 95% CI = 2.79–11.1, p trend < 0.01 for the PNI) and frailty onset at follow-up among baseline physically robust participants (OR = 1.97, 95% CI = 0.82–4.75, p trend < 0.01 for the GNRI and OR = 1.67, 95% CI = 1.13–2.46, p trend < 0.01 for the PNI). As malnutrition is a significant risk factor for frailty, both the PNI and GNRI are valuable tools in assessing the nutritional risk and had shown strong association in detecting frailty status and in predicting frailty risk, their further integration into clinical use is promising.