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This analysis investigates the relationship between the Geriatric Nutritional Risk Index (GNRI) and stroke risk in elderly populations.

March 27, 2026Open Access

Association between geriatric nutritional risk index and stroke prevalence in elderly adults: a cross-sectional analysis of NHANES 1999–2018

CWCong WangPeking University DZDong ZhouSichuan University STShuangyan TuSichuan University

Key Points

This analysis investigates the relationship between the Geriatric Nutritional Risk Index (GNRI) and stroke risk in elderly populations.
Utilized NHANES data from 1999 to 2018 with 16,092 participants aged 60+
Calculated GNRI using serum albumin levels and body weight ratio
Assessed stroke prevalence through self-reported diagnoses
Employed survey-weighted logistic regression models with demographic and clinical adjustments
12.31% of participants reported a history of stroke
GNRI was inversely associated with stroke prevalence, with each standard deviation increase linked to 12% lower odds
Quartile analysis showed significantly lower odds of stroke in higher GNRI quartiles
Stronger inverse association found in females and current drinkers

Abstract

Abstract Background Stroke remains a leading cause of mortality and disability worldwide, with nutritional status emerging as a crucial yet underexplored risk factor in elderly populations. The Geriatric Nutritional Risk Index (GNRI) represents a valuable nutritional assessment tool specifically developed for geriatric populations. This study examined the association between GNRI and stroke prevalence among elderly individuals using nationally representative data. Methods This cross-sectional analysis utilized National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2018, including 16,092 participants aged ≥ 60 years. GNRI was calculated using serum albumin levels and body weight ratio, with participants categorized into quartiles. Stroke status was determined through self-reported physician diagnosis. Survey-weighted logistic regression models were constructed with progressive adjustments for demographic, lifestyle, and clinical factors. Results Among participants (mean age 70.0 years), 12.31% reported stroke history. GNRI demonstrated significant inverse association with stroke prevalence. Each one-standard-deviation increase in GNRI was associated with 12% lower stroke odds (odds ratio OR: 0.88; 95% CI: 0.83–0.93). Quartile analysis revealed progressively lower odds compared to the lowest quartile: Q2 (OR: 0.81; 95% CI: 0.69–0.95), Q3 (OR: 0.74; 95% CI: 0.63–0.87), and Q4 (OR: 0.77; 95% CI: 0.65–0.91) (P for trend < 0.05). Multiple analytical approaches consistently demonstrated a linear inverse association. Subgroup analyses revealed a stronger inverse association in females (OR: 0.96; 95% CI: 0.95–0.98) versus males (OR: 0.99; 95% CI: 0.97–1.00) and among current drinkers (OR: 0.96; 95% CI: 0.94–0.97). Conclusions Higher GNRI scores were significantly associated with lower stroke prevalence in elderly adults in a linear dose-response manner, with the association being particularly pronounced in females and current drinkers. These cross-sectional findings suggest that GNRI may be a useful nutritional risk screening tool in geriatric populations; however, prospective studies are needed to establish temporality and causality.

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