Malnutrition in older adults: a wider view – Authors' reply

We thank Domenico Azzolino and Tiziano Lucchi for their Correspondence regarding our Review of malnutrition in older adults.1 Azzolino and Lucchi raise a concern about the low BMI cutoff point we reported for the diagnosis of malnutrition by the Global Leadership Initiative on Malnutrition (GLIM) criteria1 for adults aged younger than 70 years. We briefly touched upon the GLIM criteria in our Review, without going into much detail. One of the phenotypic GLIM criteria is a low BMI, for which we have mentioned the upper and lower boundary cutoff points by age group. Notably, the BMI cutoff points that have been proposed by Cederholm and colleagues2 are age and ethnicity specific. For people aged younger than 70 years, the cutoffs are less than 18·5 kg/m2 (Asian populations) and less than 20 kg/m2 (other populations); and for those aged older than 70 years, the cutoffs are less than 20 kg/m2 (Asian populations) and less than 22 kg/m2 (other populations). Importantly, GLIM criteria are being evaluated across settings and countries, which might result in adapted cutoff points in the future.