Soledad social en adultos mayores de zonas rurales del Ecuador: factores predictores y características clínicas asociadas
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Resumo
Introducción. La soledad y el aislamiento social constituyen problemas crecientes de salud pública en los adultos mayores, especialmente en zonas rurales. En Ecuador, esta vulnerabilidad se ve incrementada por el acceso limitado a servicios de salud, las condiciones socioeconómicas y la pérdida de redes de apoyo. El constructor de Soledad Social integra las dimensiones subjetivas y objetivas del deterioro de las relaciones sociales. Objetivo. Definir los factores predictores de la Soledad Social en adultos mayores residentes en zonas rurales del Ecuador y analizar las diferencias cognitivas, emocionales y funcionales según el nivel de Soledad Social de los participantes. Metodología. Estudio transversal con 316 adultos mayores de 65 años, seleccionados mediante muestreo no probabilístico por conveniencia en comunidades rurales del Ecuador. Se realizó anamnesis y valoración geriátrica integral. La Soledad Social se evaluó mediante la Escala ESTE-R y sus cuatro dimensiones: soledad familiar, conyugal, social y crisis existencial. La depresión se valoró con la Escala de Yesavage, el estado cognitivo con el Mini Mental State Examination (MMSE) y la capacidad funcional con la Escala de Lawton y Brody. Resultados. Los principales predictores fueron: Soledad total (R²=0.517), crisis existencial (β=0.686), tipo de convivencia (β=-0.168) y sexo (β=-0.149); Soledad conyugal (R²=0.240), tipo de convivencia (β=-0.384) y sexo (β=-0.199); Soledad familiar (R²=0.126), crisis existencial (β=0.300); y Soledad social (R²=0.031), crisis existencial (β=0.138) (todos p<0.05). Los participantes con mayor Soledad Social presentaron más síntomas depresivos, mayor crisis existencial y peor rendimiento cognitivo (todos p<0.05). Conclusión. La crisis existencial fue el principal predictor de la Soledad Social en adultos mayores rurales ecuatorianos. Estos hallazgos apoyan el desarrollo de estrategias preventivas dirigidas a identificar tempranamente a las personas con mayor riesgo de soledad no deseada. Área de estudio general: Ciencias de la Salud. Área de estudio específica: Gerontología. Tipo de artículo: original.
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