Differences in daily in-hospital physical activity and geriatric nutritional risk index in older cardiac inpatients: preliminary results

Little is known about the differences in the geriatric nutritional risk index (GNRI) status in older patients and their relationship to accelerometer-derived measures of physical activity (PA) levels. We determined both differences in daily measured PA based on the GNRI and related cut-off values for PA in elderly cardiac inpatients. We divided 235 consecutive elderly cardiac inpatients (mean age 73.6 years, men 70.6 %) into four groups by age and GNRI: older-high group, 65–74 years with high GNRI (≥92 points) (n= 111); older-low group, low GNRI (<92 points) (n= 30); very old-high group, ≥75 years with high GNRI (n= 55); and very old-low group with low GNRI (n= 39). Average step count and physical activity energy expenditure (PAEE in kcal) per day for 2 days of these inpatients were assessed by accelerometer and compared between the four groups to determine cut-off values of PA. Step counts and PAEE were significantly lower in the low-GNRI versus high-GNRI groups in the older (2,742.1 vs. 4,198.1 steps, 55.4 vs. 101.3 kcal, P< 0.001), and very old (2,469.6 vs. 3,423.7 steps, 54.5 vs. 79.1 kcal, P< 0.001) cardiac inpatients. Respective cut-off values for step counts and PAEE were 3,017.6 steps/day and 69.4 kcal (P< 0.01) in the older and 2,579.4 steps/day and 58.8 kcal in the very old cardiac inpatients (P< 0.01). Poor nutritional status, as indicated by a low GNRI, may be a useful predictor of step counts and PAEE. The cut-off values determined in this study might be target values to be attained by older cardiac inpatients.