Researchers found a better way to identify muscle loss (called sarcopenia) in older people staying in hospitals. They created a new screening tool called the modified Geriatric Nutritional Risk Index (mGNRI) that looks at nutrition, inflammation markers, and weight changes together. Testing 153 older hospital patients with an average age of 80, they discovered this new tool was better at catching muscle loss than older screening methods. The new tool correctly identified 80% of patients with muscle loss, which could help doctors start treatment earlier and prevent serious health problems in older adults.

The Quick Take

  • What they studied: Can a new nutrition screening tool that includes inflammation markers better identify muscle loss in older hospital patients compared to older screening methods?
  • Who participated: 153 older adults hospitalized in a medical facility, with an average age of 80 years old. About one-quarter of them had muscle loss.
  • Key finding: The new mGNRI tool correctly identified 80% of patients with muscle loss. When the score was below 55, patients had 8.4 times higher risk of having muscle loss compared to those with higher scores.
  • What it means for you: If you’re an older adult in the hospital, this new screening tool may help doctors catch muscle loss earlier and start treatment sooner. However, this is one study and more research is needed before it becomes standard practice everywhere.

The Research Details

This was a cross-sectional study, which means researchers looked at a group of people at one point in time rather than following them over months or years. The researchers tested 153 older hospital patients using a comprehensive assessment that included measuring their muscle mass, muscle strength, and ability to function. They also measured inflammation markers in the blood (specifically C-reactive protein) and tracked weight changes. The researchers then compared how well three different screening tools worked: the new modified tool (mGNRI), the traditional Geriatric Nutritional Risk Index (GNRI), and the Nutritional Risk Index (NRI). They used statistical methods to see which tool was best at predicting who had muscle loss based on the Asian Working Group for Sarcopenia criteria.

Muscle loss in older adults is a serious problem that can lead to falls, disability, and loss of independence. Current screening methods don’t always catch it early enough. This new tool is important because it considers both nutrition and inflammation together, which may give doctors a more complete picture of what’s happening in an older person’s body. Finding muscle loss earlier means doctors can intervene with nutrition support, exercise programs, or other treatments before the problem becomes severe.

This study has some strengths: it used clear diagnostic criteria for muscle loss, tested a reasonable number of patients, and compared the new tool to existing methods. However, it has limitations: it was done at one hospital with a specific population, so results may not apply everywhere. The study was cross-sectional, meaning we can’t prove the tool causes better outcomes, only that it identifies muscle loss. More research in different hospitals and with different populations would strengthen these findings.

What the Results Show

Among the 153 older hospital patients studied, 37 patients (24.2%) had muscle loss. The new mGNRI tool showed a special pattern: below a score of 55, each point increase in the score reduced the risk of muscle loss by about 17%. However, above a score of 55, the tool didn’t show much additional benefit—the relationship leveled off. This L-shaped pattern is important because it identifies a clear threshold where doctors should be most concerned. When the mGNRI score was below 55, patients had an 8.4 times higher risk of muscle loss compared to those with higher scores. The new tool correctly identified 80% of patients who actually had muscle loss (sensitivity of 80.4%), which is better than the older screening methods that only caught about 76% of cases.

The older screening tools (GNRI and NRI) showed a different pattern—they had a linear relationship, meaning each point increase gave consistent protection against muscle loss. When GNRI was below 98 or NRI was below 99, patients had about 7 times higher risk of muscle loss. While these older tools still worked reasonably well, the new mGNRI tool was more sensitive at catching cases of muscle loss. The area under the curve (AUC) for the new tool was 0.752, which indicates good diagnostic ability.

Previous research has shown that nutrition screening is important in older hospitalized patients, but many existing tools don’t account for inflammation. This study builds on that knowledge by creating a tool that combines nutritional assessment with inflammation markers (C-reactive protein) and weight changes. The finding that the new tool works better than older methods suggests that considering inflammation alongside nutrition gives a more complete picture of muscle loss risk. This aligns with recent research showing that inflammation plays a major role in age-related muscle loss.

This study was conducted at a single hospital, so the results may not apply to all older adults in all settings. The study design was cross-sectional, meaning we can see associations but can’t prove cause-and-effect. The study didn’t follow patients over time to see if using this screening tool actually led to better health outcomes. The sample size of 153 is moderate—larger studies would provide more confidence in the results. The study focused on hospitalized older adults, so results may not apply to healthy older people living in the community.

The Bottom Line

If you’re an older adult in the hospital, ask your healthcare team about screening for muscle loss using comprehensive assessments. Healthcare providers should consider using the new mGNRI tool as part of routine screening for older hospitalized patients, especially those with scores below 55, who should receive targeted nutrition support and exercise programs. This recommendation has moderate confidence because it’s based on one study; more research is needed. This tool should complement, not replace, other clinical assessments.

This research is most relevant to: older adults (65+) who are hospitalized, their families and caregivers, hospital doctors and nurses, geriatric specialists, and nutritionists working with older patients. This is less relevant to healthy younger adults or people living independently in the community. If you have concerns about muscle loss or are facing hospitalization, discuss screening options with your doctor.

Screening with this tool can be done quickly during hospital admission. If muscle loss is identified, benefits from nutrition support and exercise programs typically appear over weeks to months. Preventing falls and maintaining independence from improved muscle strength may take 2-3 months of consistent intervention. Results vary by individual based on overall health, nutrition, and ability to participate in exercise.

Want to Apply This Research?

  • Track weekly weight changes and note any difficulty with physical activities like standing, walking, or climbing stairs. Record these observations in your health app to share with your doctor, especially if hospitalized.
  • If you’re an older adult, work with your healthcare team to ensure adequate protein intake at meals and participate in gentle strength exercises or physical therapy as recommended. Use your app to log protein-rich foods eaten and minutes spent in physical activity each day.
  • Set monthly reminders to assess your ability to perform daily activities (walking, climbing stairs, getting up from a chair). Track your weight monthly and note any unexplained weight loss. Share this data with your healthcare provider during check-ups to catch muscle loss early.

This research describes a screening tool for identifying muscle loss in hospitalized older adults. It is not a substitute for professional medical diagnosis or treatment. If you are an older adult concerned about muscle loss, weakness, or difficulty with physical activities, consult with your healthcare provider for proper evaluation and personalized treatment recommendations. This study was conducted in a hospital setting and may not apply to all populations. Always discuss any health concerns or changes with your doctor before making decisions about your care.