Association between the global leadership initiative on malnutrition criteria-defined malnutrition and hospitalization-associated disability in older patients: An observational cohort study

Background and Aim Older adults are susceptible to hospitalization-associated disability (HAD), particularly when nutritional status is impaired. This study aimed to examine the association between GLIM-defined malnutrition and HAD in hospitalized older adults and to descriptively compare HAD-related clinical characteristics according to HAD status within GLIM malnutrition and non-malnutrition groups. Methods This prospective observational cohort study used a multicenter database to identify 166 patients aged ≥70 years who were admitted to acute care wards between February 2023 and March 2025 and were independent in ADL before hospitalization. GLIM-defined malnutrition was assessed at admission and treated as the exposure. Patients were categorized into GLIM malnutrition and non-malnutrition groups and followed until discharge to determine the occurrence of HAD. Logistic regression analysis was used to identify the independent HAD predictors. Results The mean age of the patients was 80 years; 103 were men and 63 were women. GLIM malnutrition was present in 67 (40%) patients. The occurrence of HAD during hospitalization was higher in patients with GLIM malnutrition than in those without GLIM malnutrition (48% vs. 16%, p < 0.001). Patients with malnutrition were older, frailer, and had lower body mass index. Multivariable logistic regression analysis showed that GLIM malnutrition was independently associated with HAD (odds ratio, 2.732; 95% confidence interval, 1.190–6.271; p = 0.018). Summary GLIM-defined malnutrition is independently associated with HAD in older patients. Early nutritional assessment, targeted frailty prevention, and integrated prehospital care may help reduce the risk of HAD and improve recovery after discharge.