Pacha Revista de Estudios Contemporáneos Del Sur Global · Oct 8, 2026
Association of social isolation with health status in older adults living in rural areas of Ecuador: a cross-sectional survey
By Piedra VEU, Portilla RVS, Tenecela AEP
Defined as the absence or scarcity of meaningful social relationships with family, friends, and the community, social isolation represents a priority public health problem in the older adult population. To assess the prevalence of social isolation and explore its association with health status in older adults living in rural areas of Ecuador. A cross-sectional study using a structured questionnaire, conducted in three rural parishes of Cuenca canton (Sinincay, Ricaurte, and El Valle) in 2024. Older adults over 65 years of age were included (N=314). Social isolation was assessed using the ESTE-R Loneliness Scale, with the median of the distribution established as the cutoff point (?111 points). Four health dimensions were assessed: fall risk (Tinetti), cognitive function (MMSE), depression (Yesavage), and functional dependence (Lawton and Brody). Univariate and multivariate logistic regression models were applied. The prevalence of social isolation was 50.6% (n=159). The isolated group had a higher proportion of men (39.6% vs. 23.2%; p<0.001), a higher proportion living with a partner (49.0% vs. 21.9%; p<0.001), and lower participation in physical activity (71.2% vs. 77.7%). Depression was significantly more frequent in the isolated group (49.7% vs. 36.1%; p=0.023), with an adjusted OR of 1.72 (95% CI: 1.07–2.78). Cognitive impairment was less frequent in the isolated group (33.3% vs. 51.6%; p=0.002; adjusted OR: 0.49). Functional dependence was also lower in the isolated group (46.2% vs. 59.4%; p=0.017). The overall health score was significantly lower in the isolated group (adjusted difference: ?4.12 points; 95% CI: ?6.78, ?1.46). Social isolation is associated with a higher prevalence of depression and worse overall health status in rural Ecuadorian older adults. These findings highlight the need to implement community interventions aimed at reducing social isolation and promoting healthy aging in rural settings.