The accuracy of the Geriatric Nutritional Risk Index in detecting frailty and sarcopenia in hospitalized older adults



Malnutrition, sarcopenia, and frailty are prevalent conditions amongst hospitalized elderly. They are associated with numerous adverse health outcomes. The co-existence of these problems is common, with malnutrition playing a major role in the pathogenesis of the other two. Whether nutritional screening tools are useful for frailty and sarcopenia screening needs further evaluation.


To evaluate the accuracy of the Geriatric Nutritional Risk Index (GNRI) in identifying frailty and sarcopenia in hospitalized older adults.


One hundred and fifty hospitalized patients (≥ 60 years) were recruited. Skeletal Muscle Index was obtained using bioelectrical impedance analysis. Muscle strength and physical performance were measured by handgrip strength and timed up and go test, respectively. GNRI and the Mini Nutritional Assessment (MNA) tool were used for nutritional assessment.


GNRI had lower sensitivity but higher specificity compared to MNA in predicting frailty and dynapenia. GNRI discriminated the presence of sarcopenia but not pre-sarcopenia (AUC = 0.683, p = 0.02, and AUC = 0.586, p = 0.12), while MNA did not discriminate the presence of pre-sarcopenia nor sarcopenia in the studied sample (AUC = 0.56, p = 0.25 and AUC = 0.6, p = 0.09).


Sarcopenia, frailty, and malnutrition coexisted in 26% of our sample. GNRI Score at ≤ 86.73 was 71.9% sensitive and 65.6% specific for detecting frailty and its score at ≤ 89.04 was 64.42% sensitive and 63.53% specific for detecting sarcopenia. GNRI is a simple method, which could be used for sarcopenia, and frailty screening in all elders attending primary care settings where other tools for assessing muscle mass are unavailable.

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The authors acknowledge all the participants in the study.


The authors received no financial support for the research, authorship, or publication of this article. The manuscript has not been published and is not under consideration of publication in whole or part”.

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Both authors contributed equally in study concept and design, acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript.

Corresponding authors

Correspondence to Doha Rasheedy or Wessam Helmy El-Kawaly.

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No potential conflicts of interest were disclosed.

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The study was performed in adherence to the principles established by the Declaration of Helsinki and the study methodology was reviewed and approved by the Research Review Board of the Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University.

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The present study were carried out with full respect to human rights.

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Informed verbal consent was obtained from all the participants because some of the participants were illiterate and could not provide signed consent. The verbal consent was documented in the presence of a next of kin and a nurse. The ethics committee approved using of verbal consent.

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Rasheedy, D., El-Kawaly, W.H. The accuracy of the Geriatric Nutritional Risk Index in detecting frailty and sarcopenia in hospitalized older adults. Aging Clin Exp Res 32, 2469–2477 (2020).

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  • GNRI and MNA
  • GNRI in frailty and sarcopenia
  • Sarcopenia and frailty