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.
Wang et al. (2026) studied this question.