Palabras clave
Cómo citar
Resumen
Promover un envejecimiento saludable constituye una estrategia de prevención con impacto positivo tanto en la salud de los adultos mayores como en el sistema sanitario. Las caídas representan la principal causa de lesiones en esta población y generan una elevada carga económica y asistencial. Evaluar asociación entre composición corporal, estado nutricional y riesgo de caídas en adultos mayores residentes de zonas rurales del Ecuador. Estudio transversal realizado entre 2022 y 2023 con adultos mayores de 65 años o más, reclutados mediante muestreo no probabilístico por conveniencia en centros de atención primaria y programas comunitarios de parroquias rurales de la provincia del Azuay, Ecuador. Se incluyeron residentes permanentes capaces de otorgar consentimiento informado. Se excluyeron personas con deterioro cognitivo grave, discapacidades que impidieran la evaluación por bioimpedanciometría o enfermedad aguda. Participaron 316 adultos mayores (edad media 74,3±7,6 años; rango 65–95 años), de los cuales 217 (68,7%) fueron mujeres. De 316 participantes, 85 (26,9%) presentaron riesgo alto de caídas, 58 (18,4%) riesgo moderado y 171 (54,1%) riesgo bajo. El estado nutricional fue el predictor independiente más importante de la puntuación de Tinetti en el modelo global (?=-0,339; p<0,001), en mujeres (?=-0,360; p<0,001) y en hombres (?=-0,308; p=0,004). El IMC también fue predictor significativo en el modelo global (?=-0,176; p=0,005) y en mujeres (?=-0,223; p=0,001), pero no en hombres. El estado nutricional y el IMC son los principales predictores modificables del riesgo de caídas en adultos mayores rurales ecuatorianos, especialmente en mujeres. Las intervenciones dirigidas a prevenir la malnutrición y el exceso de peso deberían incorporarse a los protocolos de prevención de caídas en la atención primaria rural.
Citas
Almeida, L. A., Dantas, B. A. da S., Rocha, K. P. de M., Araújo, M. P. D., Andrade, N. da L., Batista, F. de A. M., dos Santos Silva, R. L., Silvino, M. L. M., Barbosa, L. B. da S. F., Medeiros de Oliveira, M., Nobre, T. T. X., Távora, R. C. de O., Oliveira, A. C. de S., & de Vasconcelos Torres, G. (2025). Nutritional, cognitive, and functional deficits, frailty, and quality of life associated with fall risk in community-dwelling older adults: A cross-sectional study conducted in Brazil. Journal of Primary Care & Community Health, 16. https://doi.org/10.1177/21501319251341742
Ardaneh, M., Fararouei, M., & Hassanzadeh, J. (2023). Falls leading to fracture and nutrition among older adults: A case–control study. Journal of Health, Population and Nutrition, 42(1). https://doi.org/10.1186/s41043-023-00361-x
Beck Jepsen, D., Robinson, K., Ogliari, G., Montero-Odasso, M., Kamkar, N., Ryg, J., Freiberger, E., & Tahir, M. (2022). Predicting falls in older adults: An umbrella review of instruments assessing gait, balance, and functional mobility. BMC Geriatrics, 22(1). https://doi.org/10.1186/s12877-022-03271-5
Bennett, J. P., & Lim, S. (2025). The critical role of body composition assessment in advancing research and clinical health risk assessment across the lifespan. Journal of Obesity & Metabolic Syndrome, 34(2), 120–137. https://doi.org/10.7570/jomes25010
Campoverde, J., González, J., & Pérez, A. (2022). Risk of falls in older adults in the rural region case study Paccha Cuenca, Ecuador. International Conference on Information and Communication Technologies for Ageing Well and E-Health, ICT4AWE – Proceedings. https://doi.org/10.5220/0011000600003188
Chapelon, J., Sourdet, S., Angioni, D., Steinmeyer, Z., Briand, M., Rolland, Y., & Abellan van Kan, G. (2025). Body composition of older adults with normal body mass index: Cross-sectional analysis of the Toulouse Frailty Clinic. The Journal of Frailty & Aging, 14(1). https://doi.org/10.1016/j.tjfa.2024.100003
Chen, X., Lin, Z., Gao, R., Yang, Y., & Li, L. (2021). Prevalence and associated factors of falls among older adults between urban and rural areas of Shantou city, China. International Journal of Environmental Research and Public Health, 18(13). https://doi.org/10.3390/ijerph18137050
Choudhury, R., Park, J. H., Banarjee, C., Thiamwong, L., Xie, R., & Stout, J. R. (2023). Associations of mutually exclusive categories of physical activity and sedentary behavior with body composition and fall risk in older women: A cross-sectional study. International Journal of Environmental Research and Public Health, 20(4). https://doi.org/10.3390/ijerph20043595
Danielewicz, A. L., Freitas de Assis, G., Martins Cândido, L., Amaral Mendonça, V., Lacerda, A. C. R., Tringali, G., De Micheli, R., Bondesan, A., Carelli Pereira de Avelar, N., & Sartorio, A. (2026). Sarcopenic obesity and history of falls in older Italian adults: Associations according to different diagnostic combinations. Frontiers in Endocrinology, 16. https://doi.org/10.3389/fendo.2025.1727488
Eckert, C., Gell, N. M., Wingood, M., Schollmeyer, J., & Tarleton, E. K. (2021). Malnutrition risk, rurality, and falls among community-dwelling older adults. The Journal of Nutrition, Health & Aging, 25(5), 624–627. https://doi.org/10.1007/s12603-021-1592-8
Eckert, C. D., Tarleton, E. K., Pellerin, J., Mooney, N., & Gell, N. M. (2022). Nutrition risk is associated with falls risk in an observational study of community-dwelling, rural, older adults. Journal of Aging and Health, 34(6–8), 1125–1134. https://doi.org/10.1177/08982643221096944
Ferrara, P., Monti, C. C., Rozza, D., Fornari, C., Antonazzo, I. C., Ferrara, M. C., Bellelli, G., Brandi, M. L., Mantovani, L. G., & Mazzaglia, G. (2025). Incidence and risk factors for falls among nursing home residents in Italy: A retrospective cohort study. Aging Clinical and Experimental Research, 37(1). https://doi.org/10.1007/s40520-025-03111-7
Hashim, N. N. A., Mat, S., Myint, P. K., Kioh, S. H., Delibegovic, M., Chin, A. V., Kamaruzzaman, S. B., Hairi, N. N., Khoo, S. P. K., & Tan, M. P. (2024). Association between weight and body composition changes with falls risk in the Malaysian Elders Longitudinal Research (MELoR) study. BMJ Open, 14(11). https://doi.org/10.1136/bmjopen-2024-087358
Hidalgo, M., Ibarra, S., Pico, S., Pico, N., & Ponce, J. (2026). Sarcopenia como factor de riesgo de caídas en el adulto mayor: Revisión narrativa para la práctica clínica. Arcana Scientific Journal, 4(1), 38–52. https://doi.org/10.65305/asj.v4n1.2026.43
Jayanama, K., Theou, O., Godin, J., Mayo, A., Cahill, L., & Rockwood, K. (2022). Relationship of body mass index with frailty and all-cause mortality among middle-aged and older adults. BMC Medicine, 20(1). https://doi.org/10.1186/s12916-022-02596-7
Jiménez-Ten Hoevel, C., Queral, J., Besora-Moreno, M., Tarro, L., Sospedra-Senar, A., Tomàs-Piqueras, J., Sepúlveda, C., Valls, R. M., Pedret, A., Solà, R., & Llauradó, E. (2025). Health status, lifestyle and quality of life in older adults of rural and urban areas of Tarragona province (Catalonia, Spain): A cross-sectional descriptive study. BMC Public Health, 25(1). https://doi.org/10.1186/s12889-025-22045-3
Kupisz-Urbanska, M., & Marcinowska-Suchowierska, E. (2022). Malnutrition in older adults—Effect on falls and fractures: A narrative review. Nutrients, 14(15). https://doi.org/10.3390/nu14153123
Li, L. Z., Li, J., Xu, Q., & Ou, X. (2022). The risk of falls among the aging population: A systematic review and meta-analysis. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.902599
Lin, L. H., Liu, X. Y., Cai, C. H., Zheng, Y. K., Li, D., & Hu, G. P. (2025). Urban–rural disparities in fall risk among older Chinese adults: Insights from machine learning-based predictive models. Frontiers in Public Health, 13. https://doi.org/10.3389/fpubh.2025.1597853
Maheshwari, V., & Basu, S. (2023). Sarcopenic obesity burden, determinants, and association with risk of frailty, falls, and functional impairment in older adults with diabetes: A propensity score matching analysis. Cureus, 15(11). https://doi.org/10.7759/cureus.49601
Moradell, A., Gomez-Cabello, A., Mañas, A., Gesteiro, E., Pérez-Gómez, J., González-Gross, M., Casajús, J. A., Ara, I., & Vicente-Rodríguez, G. (2024). Longitudinal changes in the body composition of non-institutionalized Spanish older adults after 8 years of follow-up: The effects of sex, age, and organized physical activity. Nutrients, 16(2). https://doi.org/10.3390/nu16020298
Muhammad, T., Srivastava, S., Hossain, B., & Paul, R. (2022). Decomposing rural–urban differences in successful aging among older Indian adults. Scientific Reports, 12(1). https://doi.org/10.1038/s41598-022-09958-4
Mziray, M., Nowosad, K., ?liwi?ska, A., Chwesiuk, M., & Ma?gorzewicz, S. (2024). Malnutrition and fall risk in older adults: A comprehensive assessment across different living situations. Nutrients, 16(21). https://doi.org/10.3390/nu16213694
Nordling, Y., Sund, R., Sirola, J., Kröger, H., Isanejad, M., & Rikkonen, T. (2024). Body composition, balance, functional capacity and falls in older women. Aging Clinical and Experimental Research, 36(1). https://doi.org/10.1007/s40520-024-02719-5
Nowicki, G. J., Polak, M., & ?lusarska, B. J. (2024). Comparison of anthropometric indicators related to overweight and obesity by place of residence in a local community with a high social deprivation rate – a cross-sectional study. Annals of Agricultural and Environmental Medicine, 31(2), 248–254. https://doi.org/10.26444/aaem/178180
Omaña, H., Bezaire, K., Brady, K., Davies, J., Louwagie, N., Power, S., Santin, S., & Hunter, S. W. (2021). Functional reach test, single-leg stance test, and Tinetti performance-oriented mobility assessment for the prediction of falls in older adults: A systematic review. Physical Therapy, 101(10). https://doi.org/10.1093/ptj/pzab173
Pereira, C., Veiga, G., Almeida, G., Matias, A. R., Cruz-Ferreira, A., Mendes, F., & Bravo, J. (2021). Key factor cutoffs and interval reference values for stratified fall risk assessment in community-dwelling older adults: The role of physical fitness, body composition, physical activity, health condition, and environmental hazards. BMC Public Health, 21. https://doi.org/10.1186/s12889-021-10947-x
Rodrigues, F., Monteiro, D., Monteiro, A. M., & Forte, P. (2026). Interactions between BMI and age on fall risk in older adults. Epidemiologia, 7(1). https://doi.org/10.3390/epidemiologia7010018
Rossini-Venturini, A. C., Veras, L., Abdalla, P. P., Santos, A. P. dos, Tasinafo-Junior, M. F., Silva, L. S. L. da, Alves, T. C., Ferriolli, E., Romo-Perez, V., Garcia-Soidan, J. L., Mota, J., & Machado, D. R. L. (2023). Multicompartment body composition analysis in older adults: A cross-sectional study. BMC Geriatrics, 23(1). https://doi.org/10.1186/s12877-023-03752-1
Song, H., Wei, Y., Wang, Y., & Zhang, J. (2024). The mediating effect of nutrition on oral frailty and fall risk in community-dwelling elderly people. BMC Geriatrics, 24(1). https://doi.org/10.1186/s12877-024-04889-3
Stratidaki, E., Mechili, E. A., Ouzouni, C., Patelarou, A. E., Giakoumidakis, K., Laliotis, A., & Patelarou, E. (2024). A study of factors contributing to the nutritional status of elderly people receiving home care. Nutrients, 16(18). https://doi.org/10.3390/nu16183135
Thiamwong, L., Xie, R., Conner, N. E., Renziehausen, J. M., Ojo, E. O., & Stout, J. R. (2023). Body composition, fear of falling and balance performance in community-dwelling older adults. Translational Medicine of Aging, 7, 80–86. https://doi.org/10.1016/j.tma.2023.06.002
Yu, C., Meng, Z., Wang, X., & Xiao, J. (2025). Associations between sarcopenic obesity and risk of falls: A population-based cohort study among middle-aged and older adults using the CHARLS. BMC Public Health, 25(1). https://doi.org/10.1186/s12889-025-24746-1
Zhang, K., Ju, Y., Yang, D., Cao, M., Liang, H., & Leng, J. (2023). Correlation analysis between body composition, serological indices and the risk of falls, and the receiver operating characteristic curve of different indexes for the risk of falls in older individuals. Frontiers in Medicine, 10. https://doi.org/10.3389/fmed.2023.1228821
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Derechos de autor 2026 Joffre Joel Malla Sánchez, Rosa Verónica Sumba Portilla, Mariela Yessenia Guapisaca Pauta