Clinical and Functional Determinants of Malnutrition in Home Healthcare Recipients

Study Objectives: To investigate the prevalence and independent clinical and functional determinants of malnutrition among individuals receiving home healthcare services. Study Type: Cross-sectional observational study. Methods: A total of 400 patients enrolled in home healthcare services between December 2023, and March 2024 were evaluated. Nutritional status was assessed using the Mini Nutritional Assessment (MNA). Functional capacity (Barthel Index), comorbidity burden (Charlson Comorbidity Index), body mass index (BMI), dysphagia severity (EAT-10), and the presence/stage of pressure ulcers were recorded. Multivariable logistic regression was used to identify independent predictors of malnutrition. Results: Malnutrition was identified in 27.7% of participants, while 56.3% were at risk. Significant independent predictors included pressure ulcers (OR 6.62), lower BMI (OR 0.65), oral nutritional supplement use (OR 2.35), higher comorbidity burden (OR 1.40), functional dependency (Barthel score; OR 0.94), and dysphagia severity (EAT-10 score; OR 1.99; all P < .01). Strong correlations were observed between MNA scores and BMI, functional impairment, and swallowing difficulties. Conclusions: This study highlights key clinical and functional factors associated with malnutrition in home healthcare settings, particularly dysphagia, pressure ulcers, and functional decline. Findings emphasize the importance of integrated nutritional and functional assessments in home-based care and support proactive interventions to address malnutrition in this medically vulnerable population.