Geriatric nutritional risk and exceptional longevity: Findings from a large-scale population-based study

BACKGROUND: The Geriatric Nutritional Risk Index (GNRI) is a widely used prognostic marker in elderly populations, but its relevance to exceptional longevity remains unclear. METHODS: This study is a cross-sectional analysis using data from 1497 adults aged ≥60 years who participated in the Chinese Healthy Longevity and Mortality Study (CHLMS), a large-scale, population-based study designed to examine the factors influencing exceptional longevity. GNRI was calculated using serum albumin levels and weight-based indices. Multivariable logistic regression models (Models 1-3) were employed to examine the association between GNRI and the probability of reaching age ≥100. Restricted cubic spline and piecewise logistic regression were used to assess nonlinear and threshold effects. Sensitivity analyses included subgroup stratification and categorical transformations of clinical covariates and dietary behaviors. RESULTS: Among 1497 participants, 736 (49.2 %) were aged ≥100 years, with a higher proportion of females (80.0 % vs 59.1 %; p < 0.001). Centenarians had significantly lower GNRI (92 vs 101), BMI (18.0 vs 20.4 kg/m²), and ADL scores (90 vs 100), all p < 0.001. In fully adjusted models, each unit increase in GNRI was associated with an 11 % decrease in the odds of reaching age ≥100 (Model 3 OR = 0.89; 95 % CI, 0.86-0.91; p < 0.001). Centenarian prevalence declined across GNRI quartiles from 79.8 % (Q1) to 20.2 % (Q4). Restricted cubic spline analysis demonstrated a nonlinear association. Subgroup and sensitivity analyses confirmed the robustness of this association across various demographic and dietary strata. CONCLUSIONS: In centenarians, lower GNRI is associated with greater odds of exceptional longevity. However, as this is a cross-sectional study, causality cannot be inferred. Longitudinal studies are needed to explore this relationship further.