The Analysis of Geriatric Nutritional Risk Index (GNRI) for Nutritional Assessment and Health Care in Elderly Women

Eun Ju Yang

doi:10.4163/kjn.2009.42.3.234

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Yang: The Analysis of Geriatric Nutritional Risk Index (GNRI) for Nutritional Assessment and Health Care in Elderly Women

Original Article

Korean Journal of Nutrition

Korean Journal of Nutrition 2009; 42(3): 234-245.

Published online: 30 April 2009

DOI: https://doi.org/10.4163/kjn.2009.42.3.234

The Analysis of Geriatric Nutritional Risk Index (GNRI) for Nutritional Assessment and Health Care in Elderly Women

Eun Ju Yang

Department of Culinary Science, Honam University, Gwangju 506-714, Korea.

To whom correspondence should be addressed. (ejyang@honam.ac.kr)

Received 1 April 2009 Revised 14 April 2009 Accepted 17 April 2009

Abstract

Nutritional assessment for the elderly can identify health status and morbidity. However, development of Nutritional Risk Index (NRI) remains limited for elderly because of difficulties in understanding physiological mechanism of elderly. This study was performed to analyze and develop Nutritional Risk Index for Korean elderly Women (Geriatric Nutritional Risk Index, GNRI). Based on literature review, factors for NRI were identified and indices were assessed by a cross-sectional survey. The survey involved Korean elderly women (≥ 60, n = 94) in Gwangju area, and sociodemographics, lifestyle characteristics, health conditions, dietary intakes based on 24h- recall, anthropometric measures (wt, ht, BMI, waist, hip, WHR, body protein, body fat, abdominal fat, and triceps skinfold thickness), and clinical biochemistry parameters (systolic blood pressure, diastolic blood pressure, cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, prealbumin, hemoglobin, hematocrit, fasting blood glucose, HbA1c, ferritin, Zn, Ca, Na, K, Vit E, Vit B₁₂, folate, C-reactive protein) were examined relation to nutritional risk index. Based on literature review and data analyses, three NRIs were categorized (NRI I, NRI II, NRI III) and used for further analysis. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tend to be lower on aging (protein, folate, Vit B₁₂). NRI can serve as a useful tools in assessing health risk and nutritional status. Some modification of items in NRI and validity study are need to apply to Korean elderly.

Keywords: Nutritional Risk Index (NRI), Nutritional Screening, Korean elderly Women, Nutritional Status, health risk, metabolic syndrome

Figures and Tables

Table 1

General characteristics of the subjects

Table 2

Anthropometric measures and blood pressure according to the age of elderly women (Mean ± SD)

1) ANOVA 2) Different letters denote significant difference at p < 0.05 by Tukey test within the row

Table 3

Hematological status according to the age of elderly women (Mean ± SD)

1) ANOVA

2) Different letters denote significant difference at p < 0.05 by Tukey test within the Row

3) Reference 22

Table 4

Daily nutrient intakes according to the age of elderly women (Mean ± SD)

1) ANOVA

2) Different letters denote significant difference at p < 0.05 by Tukey test within the Row

3) Less than EER (Estimated energy requirements)

4) Less than AI (Adequate intake)

Table 5

Daily food intake according to the age of elderly women (Mean ± SD)(g)

1) ANOVA

2) Different letters denote significant difference at p < 0.05 by Tukey test within the Row

Table 6

Prevalence of nutrition-related risk and mean scores based on NRIs according to the age of elderly women

1) NRI I was based on having metabolic syndrome

2) NRI II (GNRI score) was calculated with the equation: Serum albumin (g/L) × 1.489 + 41.7 × present wt/usual wt (Cutoff value < 90)

3) NRI III (Dietary score, modified Mini Nutritional Assessment) was calculated by using score for change of Wt, loss of appetite, depression, stress, having pressure sores, taking medications, regular exercise, self-perception of nutrition, frequency of food groups (Cutoff value < 28)

4) %

5) Chi-square test

6) Mean ± SD

7) Different letters denote significant difference at p < 0.05 by Tukey test within the Row

8) ANOVA

Table 7

Comparison of anthropometric measures among Nutritional Risk Indices (NRIs)

1) NRI I was based on having metabolic syndrome

2) NRI II (GNRI score) was calculated with the equation: Serum albumin (g/L) × 1.489 + 41.7 × present wt/usual wt (Cutoff value < 90)

^*: T-test, p < 0.05

Table 8

Comparison of hematological status among Nutritional Risk Indices (NRIs)

1) NRI I was based on having metabolic syndrome

2) NRI II (GNRI score) was calculated with the equation: Serum albumin (g/L) × 1.489 + 41.7 × present wt/usual wt (Cutoff value < 90)

^*: T-test, p < 0.05

Table 9

Comparison of nutrient intakes among Nutritional Risk Indices (NRIs)

1) NRI I was based on having metabolic syndrome

2) NRI II (GNRI score) was calculated with the equation: Serum albumin (g/L) × 1.489 + 41.7 × present wt/usual wt (Cutoff value < 90)

^*: T-test, p < 0.05

Notes

This research was supported by grants from Korea Research Foundation.

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