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Defined as the absence or scarcity of meaningful social relationships with family, friends, and the community, social isolation represents a priority public health issue among older adults. Assess the prevalence of social isolation and explore its association with health status among older adults living in rural areas of Ecuador. A cross-sectional study using a structured questionnaire was conducted in three rural parishes of the Cuenca canton (Sinincay, Ricaurte, and El Valle) in 2024. Adults aged 65 and older were included (N=314). Social isolation was assessed using the ESTE-R Loneliness Scale, with the median of the distribution (?111 points) established as the cutoff point. 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 rate of living with a partner (49.0% vs. 21.9%; p<0.001), and lower rates of physical activity (71.2% vs. 77.7%). Depression was significantly more common 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 common 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 poorer overall health among older adults in rural Ecuador. These findings highlight the need to implement community-based interventions aimed at reducing social isolation and promoting healthy aging in rural settings.
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