Unmasking the Hidden Crisis: A Community-based Assessment of Malnutrition and Its Determinants among Geriatric Populations

Introduction: Elderly individuals often face other age-related issues, such as non-communicable diseases, mental health problems, and visual difficulties, which contribute to a vicious cycle and increase the financial burden on families and healthcare services. Malnutrition exacerbates physical and mental health problems, leading to increased morbidity and mortality rates in this population. Aims and Objectives: The present study aimed to determine the prevalence of malnutrition risk and identify its associated socio-demographics and functional determinants among adults aged ≥60 years in an urban community of Punjab using the Mini Nutritional Assessment tool. Materials and Methods: A community-based cross-sectional study was conducted in the field practice area of a tertiary care hospital. A pre-designed, pre-validated, and pre-tested questionnaire was used to gather data during house-to-house visits. The questionnaire included physical examinations, interviews, and reviews of medical records; sociodemographic details and the MNA (Mini Nutritional Assessment) tool were used. Data were analyzed using MS Excel 2021 and Jamovi. Results: Out of 341 participants, 54.3% were female and 57.2% were in the 60–69 age category. Overall, 19.6% ( n = 67) were categorized as nutritionally vulnerable using the Full MNA (16.4% at risk, 3.2% malnourished). In univariate analyses, unadjusted factors like decreased appetite, limited mobility and neuropsychological issues showed significant crude associations ( P < 0.001). However, after excluding internal MNA scale components to eliminate mathematical circularity, multivariable Modified Poisson regression demonstrated that the independent structural drivers of malnutrition risk were advanced age (90–99 years vs. 60–69 years: aPR = 3.94, 95% CI: 2.11–7.35, P < 0.001), joint family structure (aPR = 0.74, 95% CI: 0.55–0.98, P = 0.036 relative to nuclear families) and household education (illiterate/primary head: aPR = 1.95, 95% CI: 1.06–3.61, P = 0.031; middle/high school head: aPR = 1.84, 95% CI: 1.04–3.27, P = 0.035 relative to higher/professional education). Conclusion: When excluding internal MNA scale items to prevent mathematical circularity, multivariable modeling demonstrates that geriatric undernutrition risk is primarily driven by upstream structural and sociodemographic determinants rather than intrinsic clinical traits alone. Advanced age, nuclear family setups, and lower household educational attainment are the primary independent drivers of malnutrition risk. Public health strategies must target socially isolated elders in nuclear households and low-literacy domestic units alongside routine community screening.