AlfaPublicaciones · Oct 19, 2026
Social loneliness in older adults from rural areas of Ecuador: predictive factors and associated clinical characteristics
By Lituma KMS, Brito EGM, Barros JEC
INTRODUCTION: Loneliness and social isolation constitute growing public health problems in older adults, especially in rural areas. In Ecuador, this vulnerability is increased by limited access to health services, socioeconomic conditions, and the loss of support networks. The construct of Social Loneliness integrates the subjective and objective dimensions of the deterioration of social relationships. OBJECTIVE: To define the predictive factors of Social Loneliness in older adults living in rural areas of Ecuador and to analyze cognitive, emotional, and functional differences according to the participants' level of Social Loneliness. METHODS: Cross-sectional study with 316 adults over 65 years of age, selected through non-probabilistic convenience sampling in rural communities of Ecuador. An anamnesis and comprehensive geriatric assessment were performed. Social Loneliness was evaluated using the ESTE-R Scale and its four dimensions: family, marital, social loneliness, and existential crisis. Depression was assessed with the Yesavage Scale, cognitive status with the Mini-Mental State Examination (MMSE), and functional capacity with the Lawton and Brody Scale. RESULTS: The main predictors were: Total loneliness (R²=0.517), existential crisis (β=0.686), living arrangement (β=-0.168), and sex (β=-0.149); Marital loneliness (R²=0.240), living arrangement (β=-0.384), and sex (β=-0.199); Family loneliness (R²=0.126), existential crisis (β=0.300); and Social loneliness (R²=0.031), existential crisis (β=0.138) (all p<0.05). Participants with greater Social Loneliness presented more depressive symptoms, greater existential crisis, and worse cognitive performance (all p<0.05). CONCLUSION: Existential crisis was the main predictor of Social Loneliness in rural Ecuadorian older adults. These findings support the development of preventive strategies aimed at early identification of individuals at higher risk of unwanted loneliness. General study area: Health Sciences. Specific study area: Gerontology. Article type: original.