GLIM-Defined Malnutrition in Hospitalized Older Adults: Prevalence and Diagnostic Accuracy of Screening Tools

To determine the prevalence of malnutrition in hospitalized older adults using the Global Leadership Initiative on Malnutrition (GLIM) criteria as the reference method and to evaluate the diagnostic performance of commonly used nutrition screening tools.

In this prospective cross-sectional study, adults aged > 60 years admitted to internal medicine wards were assessed within 48 h of admission. Nutritional risk was screened using the Nutritional Risk Screening 2002 (NRS-2002), Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), and the European Society for Clinical Nutrition and Metabolism (ESPEN) diagnostic definition. Malnutrition was classified using GLIM criteria as the reference method. Sensitivity, specificity, predictive values, likelihood ratios, and Cohen's kappa were calculated.

A total of 202 participants were included; 33.2% (n = 67) met GLIM-defined malnutrition criteria. Malnourished participants were older and had lower body mass index, albumin, and haemoglobin levels than well-nourished participants. The prevalence of malnutrition risk was highest with MUST (61.9%), followed by MNA-SF (43.6%) and NRS-2002 (31.2%). MNA-SF and MUST showed the highest sensitivity (94%), whereas ESPEN demonstrated perfect specificity (100%) but low sensitivity (25.4%). Agreement with GLIM was strongest for MNA-SF (κ = 0.700).

In hospitalized adults aged > 60 years, one in three met GLIM-defined malnutrition criteria. Among the evaluated tools, MNA-SF provided the most favourable balance of sensitivity and agreement with the GLIM reference method, supporting its use for routine screening in geriatric inpatient settings.