title: Differences in daily in-hospital physical activity and geriatric nutritional risk index in older cardiac inpatients: preliminary results.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome Suma, Kobe, 654-0142, Japan, izawapk@ga2.so-net.ne.jp.
authors.forename: Kazuhiro P
authors.initials: KP
authors.lastname: Izawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Watanabe
authors.forename: Koichiro
authors.initials: K
authors.lastname: Oka
authors.forename: Naohiko
authors.initials: N
authors.lastname: Osada
authors.forename: Kazuto
authors.initials: K
authors.lastname: Omiya
authors.forename: Peter H
authors.initials: PH
authors.lastname: Brubaker
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimizu
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004734:Energy Metabolism / Q000502:physiology; D005260:Female; D015577:Geriatric Assessment; D006321:Heart / Q000502:physiology*; D006761:Hospitals; D006801:Humans; D007297:Inpatients; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D015596:Nutrition Assessment; D010808:Physical Examination / Q000379:methods; D018570:Risk Assessment