{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:39:07Z","timestamp":1776472747824,"version":"3.51.2"},"reference-count":50,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Nara Medical University Grant-in-Aid","award":["Nara Medical University Grant-in-Aid for a large scale prospective cohort study on healthy life expectancy."],"award-info":[{"award-number":["Nara Medical University Grant-in-Aid for a large scale prospective cohort study on healthy life expectancy."]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Malnutrition and cognitive impairment are both common and prognostically significant in elderly patients with acute decompensated heart failure (ADHF). However, the combined impact of nutritional and cognitive status on long-term outcomes remains unclear. This study aimed to evaluate the prognostic value of the Geriatric Nutritional Risk Index (GNRI) and Mini-Mental State Examination (MMSE) in elderly patients hospitalized for ADHF. Methods: We analyzed 414 ADHF patients aged \u226565 years from the NARA-LONGEVITY study. Patients were categorized into four groups based on GNRI (\u226592 or &lt;92) and MMSE (&gt;23 or \u226423) values at discharge. The primary endpoint was a composite of all-cause mortality and HF-related readmission. Results: During a median follow-up of 37.4 months, 218 patients (52.7%) reached the composite endpoint, and 168 (40.6%) died. Patients with both low GNRI and low MMSE had significantly poorer outcomes than those with high GNRI and high MMSE (adjusted hazard ratio [HR] for composite outcome: 2.16; 95% CI, 1.28\u20133.64; p = 0.004; HR for all-cause mortality: 2.21; 95% CI, 1.22\u20133.99; p = 0.009). The combined prognostic impact was consistent across age subgroups. Conclusions: The combined assessment of nutritional and cognitive status using GNRI and MMSE at discharge provides additional prognostic value in elderly patients with ADHF. These findings highlight the importance of a multidimensional approach to risk stratification and personalized care planning in this population.<\/jats:p>","DOI":"10.3390\/nu18020189","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:09:36Z","timestamp":1767712176000},"page":"189","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic Impact of Combined Nutritional and Cognitive Status on Long-Term Outcome in Acute Decompensated Heart Failure"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0516-8753","authenticated-orcid":false,"given":"Kazutaka","family":"Nogi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0656-3336","authenticated-orcid":false,"given":"Tomoya","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0271-9324","authenticated-orcid":false,"given":"Atsushi","family":"Kyodo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satomi","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuki","family":"Nakada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihiro","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1394-8509","authenticated-orcid":false,"given":"Hitoshi","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7025-0310","authenticated-orcid":false,"given":"Taku","family":"Nishida","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayako","family":"Seno","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Onoue","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiko","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"},{"name":"Department of Cardiovascular Medicine, Nara Prefecture Seiwa Medical Center, Sango 636-0802, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shungo","family":"Hikoso","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nara Medical University, Kashihara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1161\/CIRCRESAHA.121.318172","article-title":"Epidemiology of Heart Failure: A Contemporary Perspective","volume":"128","author":"Roger","year":"2021","journal-title":"Circ. 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