Estilos de vida y síntomas depresivos en adultos mayores en parroquias rurales ecuatoriana 2025-2026

Abstract

Depressive symptoms represent a priority public health concern among older adults. In Ecuador, evidence regarding their prevalence and the role of lifestyle factors in rural settings remains limited. To estimate the prevalence of depressive symptoms and assess their association with lifestyle factors among older adults living in rural parishes of Cuenca Canton. A cross-sectional study was conducted among 302 older adults (≥65 years) residing in the rural parishes of Sinincay, Ricaurte, and El Valle. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale (GDS-15), while lifestyle was evaluated using the Health-Promoting Lifestyle Profile (PEPS-I). Multivariable logistic regression was performed to identify independent factors associated with depressive symptoms. Overall, 43.0% of participants presented depressive symptoms. The mean PEPS-I score was significantly lower among participants with depressive symptoms than among those without them (130.6 ± 28.5 vs. 140.0 ± 26.9; p = 0.002). The interpersonal support, self-actualization, and stress management subscales showed the largest differences between groups (p < 0.001). In the adjusted model, an unhealthy lifestyle (OR: 2.25; 95% CI: 1.23–4.11), low income (OR: 2.26; 95% CI: 1.35–3.79), and chronic disease (OR: 2.08; 95% CI: 1.26–3.46) were significantly associated with depressive symptoms. Depressive symptoms affected nearly half of the older adults studied. An unhealthy lifestyle was associated with approximately twice the odds of depressive symptoms, independently of sociodemographic and clinical factors. These findings highlight the need for community-based interventions focused on strengthening healthy lifestyle behaviors, social support networks, and coping strategies for managing the emotional challenges experienced in later life. Keywords: Depressive symptoms; older adults; PEPS-I; lifestyle; rural areas; Ecuador; GDS-15, chronic disease.