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Resumo
Definido como a ausência ou escassez de relações sociais significativas com família, amigos e comunidade, o isolamento social representa um problema de saúde pública prioritário na população idosa. Avaliar a prevalência do isolamento social e explorar sua associação com o estado de saúde em idosos residentes em áreas rurais do Equador. Estudo transversal com questionário estruturado, realizado em três paróquias rurais do cantão Cuenca (Sinincay, Ricaurte e El Valle) no ano de 2024. Foram incluídos idosos com 65 anos ou mais (N = 314). O isolamento social foi avaliado mediante a Escala de Solidão ESTE-R, estabelecendo-se como ponto de corte a mediana da distribuição (?111 pontos). Avaliaram-se quatro dimensões de saúde: risco de queda (Tinetti), função cognitiva (MMSE), depressão (Yesavage) e dependência funcional (Lawton e Brody). Aplicaram-se modelos de regressão logística univariada e multivariada. A prevalência de isolamento social foi de 50,6% (n = 159). O grupo isolado apresentou maior proporção de homens (39,6% vs. 23,2%; p < 0,001), maior convivência com parceiro (49,0% vs. 21,9%; p < 0,001) e menor realização de atividade física (71,2% vs. 77,7%). A depressão foi significativamente mais frequente no grupo isolado (49,7% vs. 36,1%; p = 0,023), com OR ajustado de 1,72 (IC 95%: 1,07–2,78). O comprometimento cognitivo foi menos frequente no grupo isolado (33,3% vs. 51,6%; p = 0,002; OR ajustado: 0,49). A dependência funcional também foi menor no grupo isolado (46,2% vs. 59,4%; p = 0,017). A pontuação global de saúde foi significativamente inferior no grupo isolado (diferença ajustada: ?4,12 pontos; IC 95%: ?6,78, ?1,46). O isolamento social associa-se a maior prevalência de depressão e pior estado global de saúde em idosos rurais equatorianos. Esses achados destacam a necessidade de implementar intervenções comunitárias voltadas à redução do isolamento social e à promoção do envelhecimento saudável em contextos rurais.
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