Pan-Immune-Inflammatory Value (PIV) and Hemoglobin–Albumin–Lymphocyte–Platelet (HALP) scores: Associations with geriatric syndromes in older adults

Background: The Pan-Immune-Inflammation Value (PIV) and Hemoglobin–Albumin–Lymphocyte–Platelet (HALP) score are novel biomarkers reflecting systemic inflammation and nutritional status. However, their associations with comprehensive geriatric assessment (CGA) domains and geriatric syndromes have not been fully elucidated. Purpose: To investigate the relationships of PIV and HALP scores with sarcopenia, frailty, nutritional status, cognitive performance, and functional impairment in older adults undergoing CGA. Study Type: Retrospective cross-sectional study. Population: A total of 605 adults aged ≥60 years who underwent CGA at a tertiary geriatric outpatient clinic between May 2023 and February 2026. Assessment Techniques/Outcomes: PIV and HALP scores were calculated using routine laboratory parameters. CGA included SARC-F, handgrip strength (HGS), gait speed, Timed Up and Go Test (TUGT), Katz Activities of Daily Living (ADL), Lawton Instrumental Activities of Daily Living (IADL), Mini Nutritional Assessment–Short Form (MNA-SF), Clinical Frailty Scale (CFS), cognitive tests, and assessments of geriatric syndromes. Primary outcomes were sarcopenia, frailty, malnutrition risk, cognitive impairment, and functional decline. Statistical Tests: Group comparisons were performed using Chi-square, Fisher's exact, and Mann–Whitney U tests. Spearman correlation analyses, adjusted linear regression models, and adjusted binary logistic regression models controlling for age, sex, Charlson Comorbidity Index, and body mass index were applied. Results: The median age was 79 years, and 65.1% of participants were female. Higher PIV and lower HALP scores were consistently associated with worse CGA outcomes. Individuals with sarcopenia, frailty, and depression risk exhibited significantly higher PIV and lower HALP scores (all p  < 0.05). In adjusted analyses, higher PIV scores were independently associated with lower gait speed, poorer ADL and IADL performance, greater frailty, and increased sarcopenia risk. Lower HALP scores were independently associated with reduced gait speed, poorer ADL, IADL, and MNA-SF scores, as well as increased frailty and sarcopenia risk. HALP additionally demonstrated significant associations with cognitive performance measures. Data Conclusion: PIV and HALP are independently associated with major domains of geriatric vulnerability, including sarcopenia, frailty, functional decline, and nutritional impairment. These readily available biomarkers may provide complementary information for risk stratification and geriatric assessment in older adults.