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The objective was to determine the relationship between various factors and food insecurity, using a cross-sectional analyti-cal study of 400 older adults living in rural and urban areas of the Azuay province in Southern Ecuador. Food security was measured using the Latin American and Caribbean Food Security Scale (ELCSA). The data was analyzed using version 15 of the Statistical Package for the Social Sciences (SPSS) program, and the odds ratio with 95% confidence interval (CI) was used to determine statistical association. The incidence of food insecurity was higher in older adults who live in households comprised only of members above the age of 18 (43.7%) and in rural zones (65%). Food insecurity is high in older adults, especially in individuals who live in rural areas and who have low levels of education and low socioeconomic levels. It is necessary to implement public policy and preventative strategies to mitigate the risk of food insecurity in older adults.

While life expectancy is increasing due to scientific advancement, quality of life in aging depends, among other factors, on the nutritional status and socioeconomic status of older adults. To determine socioeconomic status and its association with nutritional status as a predictor of food insecurity among older adults in southern Ecuador, a cross-sectional study of 188 older adults in urban areas and 212 in rural areas was conducted. Nutritional status, food insecurity, and socioeconomic status were measured. Data were analyzed using SPSS v 15.0 for descriptive statistics and bivariate analysis. Of the older participants, 59% had malnutrition, the majority women, and 24.7% were in poverty. Underweight was associated with low socioeconomic status for adults between 65 and 74 years old (OR = 7.710; CI 95% = 1.691–35.147), while obesity was associated with low socioeconomic status and non-manual labor (OR = 3.048; CI 95% = 1.268–7.326). Over 80% of older adults living in homes without children younger than 18 and at low socioeconomic status had food insecurity. The prevalence of underweight, overweight, and obesity points to widespread nutritional problems, especially in rural areas, that are significantly associated with low socioeconomic status. This demonstrates the need for multidisciplinary programs and government policies that can contribute to reducing food insecurity among the highly vulnerable older population.

The authors regret to inform that the affiliation of the author María Elissa Torres is wrong, she made this research and writing as part of Universidad de Cuenca, in Cuenca, Ecuador not in UDLA, Quito, Ecuador as it is published. The authors would like to apologise for any inconvenience caused.

Background: hypertension is a public health problem, 38 million individuals die each year from non-communicable diseases, and 16 million die before reaching 70, in addition to its close relationship with the lifestyles. Objective: establish the Prevalence of cardiovascular risk in hypertensive patients over 50 years of age and its relationship with lifestyle in the outpatient clinic of the Type C Maternal and Child Center and Emergencies IESS Cuenca, in the year 2020. Method: a cross-sectional, quantitative analytical study was carried out with 159 people over 50 years, using the Framingham test to determine cardiovascular risk, the FANTASTIC survey before the signature of the informed consent. The data was analyzed with the SPSS free version program with descriptive statistics. Results: the mean age of cardiovascular risk was between 61 to 70 years with 40.3%, of females with 60.4%, basic education with 67.9%, urban residence of 89.3%, with low cardiovascular risk of 1.3%, moderate of 6.9%, high with 6.3% and very high with 85.5%, with a bad lifestyle of 13.2%, regular of 67.9%, good of 4.4% and excellent of 14.5%. A positive association was found between high cardiovascular risk and very high with lifestyle bad. Conclusion: a higher prevalence of women, between the range of 61 to 70 years with the mean age of 68.9 years, of urban origin, highlighting that cardiovascular risk increases in the population with a bad lifestyle.

Background: establishing the weight of the older adult is important for their health; however, the estimation of weight by doctors and health personnel is usually imprecise, adding to the questioning of the instruments used to take it. Objective: to validate the weight measurement of the chair scale versus the floor scale in older adults of Cuenca city using the Bland-Altman graphic method. Methods: a concordance study was carried out in 204 older adults from the “Centro de Atención al Adulto Mayor” in Cuenca. The demographic and anthropometric data was conducted by a form created by the authors. The weight was measured on the ADE model M304641-01 floor scale and on the ADE model M400660 chair scale. The data was tabulated and graphed in the statistical software SPSS version 25.0. The analysis of the information was based on the Bland-Altman method with calculations of limits of agreement with 95% confidence intervals and bias for which statistical significance <0.001 was defined. Results: the mean difference between the scales was -0.31617 kg with a bias of <0.001, with the chair scale, being the one that overestimates the calculated weight, this difference raises to -0.6 kg in patients with 100 kg or higher. Conclusions: using the Bland-Altman method, the mean difference between the scales was -0.32 kg, which is statistically significant, so there is no concordance between the two scales analyzed.

Background: Type 2 Diabetes is the seventh leading cause of mortality in the world. In Ecuador, the prevalence has increased in people over 35 years of age. The social determinants of health are risk factors for non-adherence to Type 2 Diabetes treatment. Objective: to determine the prevalence of non-adherence to type 2 diabetes treatment and its relationship with the determinants of health, at the Azogues IESS Specialized Comprehensive Rehabilitation Center, September 2020- February 2021. Methods: a cross-sectional analytical study was carried out in 121 patients from the Azogues Specialized Comprehensive Rehabilitation Center, in men and women with Type 2 Diabetes, through telephone interviews, applying the Morisky-Green test. Lifestyle Measurement (IMEVID). Stratification of the INEC Socioeconomic Level and Duke scale. The data were analyzed using SPSS version 20 and Excel 2017. Results: the average age was 69 years (SD 11.2). 50.4% corresponded to the male sex. Non-adherence to Type 2 Diabetes treatment was presented in 51.2%. The statistically significant social determinants of health were: low socioeconomic level with PR 5.5 (95% CI 1.9-15.9; p = 0.001), low family support with PR 2.2 (95% CI 1.1-12 , 2; p = 0.024), polypharmacy with PR 2.2 (95% CI 1-4; p = 0.036) and unhealthy lifestyle with PR (95% CI 1.6-7.7; p = 0.001 ). Conclusion: a statistically significant association was found between low socioeconomic status, low family support, polypharmacy and unhealthy lifestyles with non-adherence to treatment.

Background: the elderly are at risk of presenting pathologies such as malnutrition and depression. Its early detection can prevent health complications in this population group. Objective: to determine the prevalence of the risk of malnutrition and its relationship with depression, in the elderly in the urban area of the Cuenca canton, November 2021 - April2022. Methods: cross-sectional analytical study, which included 350 older adults from the urban area of Cuenca. Nutritional status was assessed using the Mini Nutritional Assessment and the presence of depression using the Geriatric Depression Scale. Data were tabulated in the free SPSS Version 21program. For the analysis, descriptive statistics were used such as frequency, percentage, measures of central tendency, measures of dispersion (standard deviation) and for association: prevalence ratio (PR), with Confidence interval (CI) of 95%, and Chi Square Pearson's for statistical significance, with its value p < 0.05. Results: the prevalence of malnutrition risk was 36%. The prevalence of malnutrition was 8.86%. The most prevalent group was 65 to 74 years old (54.86%). The risk of malnutrition and malnutrition were significantly associated with age, marital status, and educational level (p < 0.001). In addition, there is a strong association between the risk of malnutrition and depression, the PR of 7.293 (95% CI 4.678 - 11.369, p <0.001). Conclusions: the prevalence of malnutrition risk was 36% and was associated with age, marital status, educational level and depression.

Background: older adults are a nutritional risk group, as a cause of poor food consumption, alterations in their cognitive function can present alterations in their nutritional status. Objective: to determine the prevalence of cognitive impairment and its relationship with food consumption in older adults in urban and rural parishes in the Canton of Cuenca, December 2021 - March 2022. Methods: cross-sectional analytical study in 238 older adults who answered the Neuropsi test and the ECAAM survey, residents of the Canton of Cuenca, who gave informed consent. The SPSS vs 21 program was used, descriptive statistics were used such as frequency, percentage, measures of central tendency as average, measure of dispersion: standard deviation and for association: prevalence ratio, with 95% CI and for statistical significance chi square with the p-value less than 0.05. Results: The prevalence of cognitive impairment was 28.99% and poor food consumption was 41.18%. The most prevalent group with cognitive impairment were those older than 85 years (57.89%). The prevalence of risk of cognitive impairment due to poor food consumption was 35.71%, however, no relationship was determined between cognitive deterioration and food consumption since the p value using chi square was 0.056 and PR was 0.680 (95 CI % 0.458 – 1.009). Conclusions: The prevalence of cognitive impairment was 28.99% and there was no relationship between cognitive impairment and food consumption, but cognitive impairment was associated with age.

Introduction: the appearance of the new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or Coronavirus Disease 2019 (COVID-19) and its rapid spread, caused a worldwide health emergency. This virus mainly affects the respiratory system, but also the gastrointestinal tract.Objective: to identify if the secondary gastrointestinal manifestations to COVID-19 infection are an important phenotypic expression of this pathology.Methodology: a systematic search was carried out in scientific medical journals in the databases: Scielo, PubMed, SpringerLink, Wiley Online Library, Scopus with the following terms “Gastrointestinal manifestations due to COVID-19”, “Gastrointestinal symptoms due to SARS-CoV2”, “Gastrointestinal alterations in COVID-19”, published in English and Spanish between 2020 and 2021.Results: the most frequent gastrointestinal symptoms were diarrhea, nausea, vomiting, anorexia and abdominal pain. The physiopathology of gastrointestinal manifestations depends on angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2). The detection of viral RNA in feces as a diagnosis has been detected in 53.4% of infected patients, other methods described are not definitive. Finally, the treatment of gastrointestinal manifestations due to COVID-19 is symptomatic.Conclusions: the advances in the epidemiology, pathogenesis, clinical characteristics, means of diagnosis and treatment of COVID-19, show that secondary gastrointestinal manifestations occur in a manner and frequency variable, allowing to face this epidemic disease more effectively.

Background: The increase in older adults worldwide increases the incidence of mortality and morbidity associated with lack of physical activity and poor nutritional status. Objective: To determine the nutritional status and its association with the level of physical activity in older adults in the province of Azuay, 2020. Method: Retrospective cross-sectional analytical study with anthropometry, physical activity questionnaire and Mini nutritional assessment (MNA) applied to 400 older adults (AM), with prior signing of the informed consent. The data were analyzed in the SPSS v.15.0 program, descriptive statistics were used such as frequency and percentage, mean, standard deviation and Odds Ratio with a 95% confidence interval and for statistical significance, (chi) ^ 2 with its p value. Results: Malnutrition according to BMI was 59.6%, predominating overweight with 30.8%; 33.2% of these presented low physical activity; there was a significant association between malnutrition according to BMI and low physical activity with men (p = 0.013), manual work (p = 0.004); association of overweight with low physical activity and manual work (p = 0.019); obesity associated with low physical activity and age between 75 to 84 years (p = 0.028), male (p = 0.029), low education (p = 0.029), manual work (p = 0.002); According to MNA, malnutrition was found in 39.5% of these, 42.4% had low physical activity; relationship between malnutrition and low physical activity in ≥ 85 years (p = 0.000), male (p = 0.000), with partner (p = 0.000), low education (p = 0.000), rural resident (p = 0.00), manual work (p = 0.000). Conclusion: Malnutrition existed in most of the MA according to BMI and MNA, in addition to a statistically significant association between these and low physical activity.

Elderly adults in southern Ecuador often distrust nutritionists’ advice when implementing changes to their dietary practices. This distrust is no overt disregard for expert nutritional knowledge but rather the result of structural and situated practices that combine suspicion, misinformation, financial limitations, and family care. In this article, we examine eating practices among elderly adults in southern Ecuador in order to understand how nutrition distrust is constructed. In doing so, our aim is to understand how elderly adults incorporate—or not—expert nutritional knowledge into their eating practices. By ethnographically documenting daily eating practices among elderly adults in their homes, alongside expert nutritional discourses, our findings reveal that there is first, a local understanding of “eating healthy” connected to lived realities (e.g. farming practices, agricultural toxicity, age, education, polypharmacy, kinship ties), and second, a disconnect between expert nutritional knowledge and eating practices linked to how knowledge is produced and disseminated (e.g. power relations, scientific vocabulary, perceptions of health). Understanding how elderly adults build trust around eating can be a fertile ground for promoting more effective and suitable dietary advice among specific communities or groups like elderly adults.

BACKGROUND: The gradual decrease in the biological functions of the elderly predisposes them to a potential risk of suffering head injuries According to the epidemiological profile of the Ecuadorian elderly in 2006, showed that head injuries constituted the eighteenth cause of morbidity and mortality. GENERAL OBJECTIVE: to determine the prevalence of severe head injury and associated factors in older adults of the Trauma Center of the Vicente Corral Moscoso Hospital of the canton of Cuenca between the years 2014-2020. METHODOLOGY: retrospective cross-sectional analytical study, in 250 medical records of elderly patients, a data collection sheet was used which included all the variables a studied that were included in a statistical database. The data were analyzed and processed in the SPSS version 15 program and descriptive statistics were used as frequency and percentage, measures of central tendency as average and measures of dispersion as standard deviation. In addition, Odds ratio (OR) with a confidence interval (CI) of 95% and Chi square with its p-value for statistical significance less than 0.05 were used to search for statistical association. RESULTS: 250 medical records of older adults were studied, 55.2% were men, 42.8% were young older adults (65-74 years), 79.2% were residents of an urban area. The prevalence of severe TBI was 15.6%, the most prevalent factor associated with severe TBI was falls (14.0%), OR 36.823 (95% CI, 13.745-98.647), (p=0.001); followed by chronic diseases (11.2%) OR 2.063 (95% CI, 1.121–3.796) (p= 0.024). CONCLUSIONS: the prevalence of severe TBI was 15.6% and was mainly associated with falls and chronic diseases.

Nutrition labeling is a public health tool that allows consumers to choose healthier foods and beverages. For this reason, there are protocols in place to monitor the food environment. The purpose of this study was to evaluate the consistency of nutrition labeling on packages for processed and ultra-processed products (UPPs) found at the main supermarkets in Cuenca, Ecuador. We conducted a descriptive cross-sectional study in which we identified label components on the packages of 1725 foods and beverages—including the nutrition table, statement on sweeteners, ingredient list, and the traffic light (TL) label—and determined the degree of consistency between the indicators reported on the traffic light label and those obtained from the information in the nutrition table. We found that 24% of products had inconsistencies in the traffic light label, and 10.9% of products had inconsistencies in the indicator for sugar specifically. The majority of inconsistencies were in the medium indicators for sugar (K = 0.68) and fat (0.75). The products with a medium indicator for sugar had a 1.98 (p < 0.05, 95% CI 1.15, 3.39) times higher chance of having inconsistencies in comparison with the low indicator. Health authorities must create new guidelines to allow for continued monitoring of the nutrition and traffic light labels on products accessible to consumers.

Background: older adults suffer many anatomical, functional, and hormonal changes due to aging and socioeconomic inequality increases the risk of malnutrition. General objective: to determine the association between nutritional condition and socioeconomic status among older adults in Azuay province, 2019. Methodology: a cross-sectional descriptive study in 400 older adults of 65 years or above was made in Azuay province. Moreover, anthropometric measurements were made and the INEC survey about socioeconomic stratification was applied besides the Mini Nutritional Assessment (MNA). The results were analyzed in SPSS 15.0 applying frequencies, and average and standard deviation. Odss Ratio was used for association with 95% confidence interval and for statistical significance with its p-value. Results: according to body mass index (BMI) it was found 59% of malnutrition and 30, 8% of overweight. The majority of older adults suffering malnutrition have a socioeconomic level of 42, 9% and 36, 11%. Nutritional status of thinness is associated to an age range between 65 and 74 years (OR 7,710) (IC95% 1,691 – 35,147). There is a significant relation between obesity, low socioeconomic level and high level of education (OR 3,813) (IC95% 1,119-12,994) and non-handwork job (OR 3,048) (IC95% 1,268-7,326). Conclusion: the majority of the population suffers malnutrition and prevalence of overweight. A statistic association between low socioeconomic level and thinness, and obesity, high level of education and non-handwork job were found.

Background: older adults are the population with the highest demand for health services, needing a considerable degree of care, generally provided by a formal institutionalized caregiver, being a comprehensive work that predisposes to overload syndrome. Objective: to determine the prevalence and associated factors of the formal caregiver overload syndrome of the elderly in the gerontological centers of Azuay, in the year 2020. Materials and Method: analytical-cross-sectional study in 202 formal caregivers from the gerontological centers of Azuay; whose data were obtained using questionnaires and the Zarit scale, with prior authorization. For the statistical analysis, frequency, percentage, average, standard deviation, ODDS RATIO with 95% CI, and Chi square with p value <0.05 were used to determine statistical significance. Results: The prevalence of overload in formal caregivers of gerontological centers in Azuay was 47% with a predominance of light overload (66.3%); associating to married marital status (OR: 1.93, 95% CI 1.09 - 3.4, p = 0.03), work experience ≤ 3 years (OR: 1.89, 95% CI 1.07 - 3.34, p = 0.03), daily workday ≥ 12 hours ( OR: 2.10, 95% CI 1.10 - 4.02 value p = 0.03) and not using institutional protocols for managing job exhaustion (OR: 1.71, 95% CI 0.28 - 10.47, p = 0.00). Conclusion: The prevalence of the overload syndrome in Azuay is similar to the percentage of the world and regional bibliography, in addition, it was found that being married, and certain working conditions in formal caregivers presented a statistically significant association. Key words: Older adult. Formal caregiver. Overload syndrome. Job exhaustion. Zarit scale.

BACKGROUND: there are currently 700 million older adults worldwide. Suicide is one of the ten leading causes of death in this population, who are 1.5 times more likely to commit suicide than young people. GENERAL OBJECTIVE: to determine the prevalence of suicide risk and associated factors in older adults in an urban parish and a rural parish in the canton of Cuenca. METHODOLOGY: transversal analytical study in 400 older adults of the urban parish Yanuncay and rural El Valle, a survey was carried out after signing the informed consent and obtained: sociodemographic data, Plutchik's suicide risk scale, medical, psychiatric, psychological, family factors. The data was analyzed by frequency, percentage, measures of central tendency and dispersion, Odds Ratio with 95% confidence interval, chi-square with p value less than 0.05. RESULTS: suicide risk in Yanuncay of 22.5%, associated with chronic disease OR2,979 (IC95%1,361-6,521), (p=0,005); anxiety OR12,495 (IC95%6,022-25,928), (p=0,000); suicidal ideation OR134,357 (IC95%17,410-1036,870), (p=0,000), family history of suicide OR14,757 (IC95%4,553-47,824), (p=0,000). El Valle suicide risk of 33.1%, associated with depression OR14,010 (IC95%6,495-30,218), (p=0,000); suicidal ideation OR17,095 (IC95%5,534-52,809), (p=0,000), family history of suicide OR7,115 (IC95%2,900-17,456), (p=0,000). CONCLUSIONS: the suicide risk in Yanuncay was 22.5% and was associated with chronic illness, anxiety, suicidal ideation and family history of suicide, while; the suicide risk in El Valle was 33.1% and was associated with depression, suicidal ideation and family history of suicide.

Introduccion: La actividad fisica puede influenciar positivamente sobre la calidad de vida de adultos mayores, mejorando su funcionalidad y previniendo la discapacidad; de ahi la importancia de buscar una herramienta que permita evaluar la actividad fisica en personas mayores de 65 anos.Objetivo: Establecer la confiabilidad del cuestionario Internacional de Actividad Fisica version corta, en una poblacion adulta mayor de 65 anos de la sierra ecuatoriana.Material y metodos: Se determinaron los niveles de actividad fisica alto, moderado y bajo en 387 adultos mayores usando el cuestionario Internacional de Actividad Fisica version corta (IPAQ-C). Fueron incluidos adultos mayores de 65 anos de ambos sexos. El cuestionario se aplico en dos ocasiones con un lapso de 1 a 2 semanas (IPAQ1 e IPAQ2). Se utilizo el coeficiente de correlacion intraclase para la fiabilidad intraobservador, el alfa de Cronbach para la consistencia interna. Los resultados fueron analizados en SPSS.Resultados: El mayor numero de adultos mayores participantes estuvieron entre los 65 a 74 anos (64,6%) y en su mayoria mujeres (63,6%). El grupo etario entre 65 a 74 anos, fue el grupo que presento mayor nivel de actividad fisica alta. Con el aumento de la edad el nivel de actividad fisica alta disminuyo (p < 0,001). Los valores del Alfa de Cronbach para el IPAQ1 e IPAQ2 fueron 0,685 y 0,701 respectivamente. La confiabilidad intra-observador total fue de 0,866.Conclusiones: Los resultados muestran niveles elevados de actividad fisica. Los valores hallados para medir la confiabilidad y la consistencia interna permiten concluir que el IPA-C es adecuado para la evaluacion del nivel de actividad fisica de la poblacion adulta mayor de la sierra ecuatoriana.

Malnutrition and its underlying factors are a worldwide concern; as many of them can be modified, which in turn would positively impact healthy aging. The objective of this study was to determine the prevalence of malnutrition and associated factors among the elderly of Gualaceo, Ecuador, using a cross-sectional design with 250 elderly participants. Sampling was probabilistic, stratified and randomized in Gualaceo, Ecuador. Nutritional status was assessed using the Mini Nutritional Assessment; depression with the Yesavage Geriatric Depression Scale; physical activity with the International Physical Activity Questionnaire, socioeconomic level with the Survey Of Stratification of the Socioeconomic Level of the National Institute of Statistics and Censuses, and laboratory parameters. Descriptive statistics, prevalence ratios with 95% confidence intervals were calculated and multivariate analysis was conducted. The prevalence of malnutrition was 20.4%, the risk of malnutrition 47.2%, and 32.4% had a satisfactory nutritional status. The mean age was 76.3 (±8.2) years. One fifth of the sample of elderly residents of the Gualaceo town had malnutrition and is associated with depression, sedentary lifestyle, low socioeconomic status and anemia, ratifying malnutrition as a public health problem.

Background: It has been proven in several studies that the use of drugs able to prolong the QT interval corrected by Bazzet’s equation (QTcB) increases with age and cardiac diseases; therefore, an electrocardiogram screening may provide valuable information about cardiovascular vulnerability of the elderly. Goal: To identify the prolongation’s prevalence of the interval QTcB and the clinical-pharmacological factors associated among the elderly staying in gerontological and geriatric centers in the urban area of Cuenca. Methods: A cross-sectional study involving 363 elderly residents of gerontological and geriatric centers of the urban area of Cuenca, which had an agreement with the Ministry of Economic and Social Inclusion during the year 2016; besides, all participants signed the informed consent. Participants were selected from seven different centers in a weighted and random fashion. A previously validated questionnaire was used; and, a EKG using standardized techniques was obtained. The QTc interval was defined using the Bazett’s equation; prevalence ratio with 95% CI and p<0.05 of significance was used to define the association analysis. Binary logistic regression was used for the bivariate analysis. The statistical software packages used were SPSS v19 and Epi Info v7. Results: The average age of the participants was 80±10 years, 52% were male and 48% female; 49,3% were singles and 25,6% were widowed; 90,4% were economically inactives, 78% had primary education. The prevalence of QTcB prolongation was 17,9%. Arterial hypertension, diabetes type 2, atrial fibrillation, cardiac failure, heart attack, bradycardia and hypotiroidis showed don’t be an associated factor. Significant association between chronic renal failure, valproic acid, allopurinol, alprazolam, clonazepam, and fluoxetine was found. Conclusions: The prolongation of the QTcB interval and the use of drugs with potential risk to prolong the aforementioned interval in elderly people was high

Introduction: 6.5% of the total population in Ecuador are people over 65 years old, and it is expected that by 2020 it will be 7.4%. In this process there are several anatomical and physiological changes, being one of the most compromised structures, the foot. In spite of this, this pathology is not very valued and there are few referent studies. Objective: to determine the prevalence of podiatric disorders and associated factors in older adults of the gerontological centers of the canton of Cuenca. Methodology: a cross-sectional study in 136 older adults, who underwent a physical podiatric examination, once the inclusion criteria were met: adults over 65 years of age in the gerontological centers of the canton of Cuenca who signed the informed consent. The data were analyzed and processed in the SPSS version 15 program and descriptive statistics were used as frequency and percentage, measures of central tendency as average and dispersion measures as standard deviation. To search for statistical association, odds ratio (OR) was used with a 95% confidence index (CI) and chi square with its p value for statistical significance less than 0.05. Results: 136 older adults were studied, 59.6% were women, 34.6% were between 65 and 74 years old and 34.6% between 75 and 84 years old. 71.3% have resided in rural areas and 66.2% have primary education. 100% of the study population presented some type of podiatric injury and the dermatological pathology was the most prevalent with 97.1%, followed by biomechanical pathology with 80.1% and vascular and neuroperipheral pathology with 61.8 %. There was 2.3 times higher prevalence of vascular and neuroperipheral pathology in patients with high BMI; this association was significant (95% CI 1.026-5.306, p value <0.05). Conclusions: all older adults who participated in the study had at least one type of podiatric injury. The pathology of the dermatological type was the most prevalent and together with the vascular and neuroperipheral ty

Background: Hypothyroidism is a disease that increase its prevalence with age and has relation with metabolic complications that we can avoid with an early diagnosis and treatment. Objectives: To find the prevalence of primary hypothiroidism in elderly patients that live in the urban zone of Cuenca in 2015. To meet the relation of this disease with sociodemographic and clinic variables. Materials and methods: A cross sectional study that enroled 387 patients with 65 and over years old that live in the urban zone of Cuenca in 2015. Sample: 387 people (22015 universe according to the census of 2010). We have used the statistical software SPSS with its 22 version, we calculate the prevalence of hypothyroidism and its associated factors (age, sex, BMI, HBP, low HDL, high LDL, hypertrigliceridemia, metbolic síndrome) using prevalence ratio with confidence interval 95% Chi scuare and p (< 0,05). Results: The prevalence of primary hypothyroidism in elderly people was 32,8%. We find statistical association with sex, HBP and low HDL. The hypothyroid group has a higher prevalence (RP 1,6) of Hypertension than the euthyroid group. Conclusions: The prevalence of primary hypothyroidism in elderly people of the urban zone of Cuenca is high, and is higher than the reports ion other studies The early diagnosis and treatment can to prevent cardiometabolic complications given its positive association with the mentioned variables

The lack of standardized cut-off values for the surrogate methods to diagnose Insulin resistance (IR) and the fact that the sensitivity of these methods have been studied in specific populations have limited their use in clinical routine. We developed a system that could aide to diagnosis IR in elderly people, analyzing four surrogate methods of IR estimation using a k-means clustering algorithm. Study subjects included 119 nondiabetic participants over 65 year old from Ecuadorian highlands. Blood tests included a two-point oral glucose test tolerance. The k-means clustering algorithm, was applied in one-dimensional experiments for the Homa-IR, Quicki, Avignon and Matsuda. The population was divided into three clusters: C N with normal values, C IR with IR and C a with values in between. The number of individuals classified in each C Ir was very different according to each method. With the cut-off values obtained, for each method, the system for the evaluation of IR in elderly people was developed. Our work is intended to aid physicians in the early detection of IR by using information from diverse methods.

Introduction: The population of older adults has increased, and with it chronic non communicable diseases such as hypertension, considered a public health problem. Objective: To determine the frequency of hypertension in older adults of urban parishes in the city of Cuenca. Methodology: A descriptive study was carried out in 378 older adults. It was considered hypertensive after two blood pressure measurements taken at least one week apart, in which the systolic blood pressure was greater than or equal to 140 mmHg and diastolic blood pressure greater than or equal to 90 mmHg. Hypertensive people were characterized according to sociodemographic parameters, family history, nutritional status and physical activity. For the sampling, census areas of each parish were used, with simple random sampling. The data were analyzed and processed in the SPSS program version 15.0, using frequency distribution, measures of central tendency: Mean and dispersion measures: Standard deviation. Results: The frequency of hypertensive was 52.5%, 65.1% of hypertensive patients were women and 34.9% were men. 57.6% of hypertensive patients were between 65 and 74 years of age. 41.2% had complete primary education. 76.4% did not have an occupation with salary remuneration. 51.2% had no family history of hypertension. 40% performed physical activity moderately and 41.9% presented obesity. Conclusion: The frequency of hypertension in urban older adults exceeds the global figures established for this age group. © 2018 Revista Latinoamericana de Hipertension. All rights reserved.

Objective Determine the prevalence of the metabolic syndrome, the level of physical activity and the association with these factors in the elderly from the Ecuadorian highlands. Methods Cross-sectional study that evaluated 387 older adults from Cuenca-Ecuador, who wished to participate and signed the informed consent. The diagnosis of metabolic syndrome was made using the criteria of the National Program of Education on Cholesterol and the Adult Treatment Panel III, for the value of Abdominal Circumference the criteria used for the Asian population was considered. The level of physical activity was evaluated by the short version of the International Physical Activity Questionnaire. The groups with and without metabolic syndrome were compared using the chi-square test and student’s t-test. The analysis of variance was used to evaluate the association between the components of the metabolic syndrome and the level of physical activity. Results The prevalence of metabolic syndrome was high (59.9 %), as well as the high level of physical activity (45 %), however, there was no significant association between the metabolic syndrome and physical activity level. Conclusions Older adults diagnosed with metabolic syndrome presented the same level of physical activity as individuals without this diagnosis. It is necessary to confirm the present findings using direct measurement instruments of physical activity

Objective: Determine the relationship between quality of life of the elderly, family functionality and sociodemographic factors. Also, to determine the family's perception of the quality of life of the elderly. Methodology: There was a mixed quantitative cross-sectional analytical and qualitative study of ethnographic type. The study included 146 participants who met the inclusion criteria and who signed the informed consent. The quality of life was measured with the WHOQOL-BREF questionnaire and the family APGAR was used to provide family support. To search for the association, the RP was used with a CI95% and for statistical significance the chi square was accepted a value of p <0.05. For the qualitative, the focal group technique was used. Results: Low quality of life was concentrated between 23 and 28%, family dysfunction was related to poorer quality of life and health (RP 1,8 CI95% 1,094–3,008), social relationships (RP 2,0 CI95% 1,223–3,515) and the environment (RP 2,8 IC95% 1,632–5,087). Relatives perceive as factors that favor quality of life are a good health, work, participation, affection and solidarity. Conclusions: Quality of life is related to family functionality in three of its four dimensions

Background: attend an older adult can be a stressor to overload the person performing this work. Overload syndrome is characterized by insidious and multisintomatic with medical, economic, family and social impact on the caregiver. Objective: to determine the prevalence of caregiver burden the elderly and factors associated syndrome. Methodology: analytical cross-sectional study, which evaluated 239 elderly caregivers, the Gualaceo parish, during the period March-June 2016. The instruments used were validated by pilot survey test retest reliability (Cronbach's alpha 0.948, Pearson's r 0.935). The data were tabulated in the SPSS Statistics software V 20. He characterized the population using descriptive statistics and to determine association, bivariate and multivariate analysis was done. Ethical standards and informed consent were applied. Results: the prevalence of overload syndrome was 7.95%. The average age of caregivers was 46.19 years (± 14.08) and older adults 80.81 years (± 9.05). There was no statistically significant association between the syndrome and the demographic and socioeconomic characteristics of caregivers and older adults. Factors associated with overload were: time care (p 0.002), daily hours dedicated to this activity (PR 7.70 IC95%: 2.83–20.92; p 0.000); dependence (PR 4.60 IC95%: 1.74–12.12; p 0.000) of elderly and family dysfunction (PR 4.44 IC95%: 1.69–11.62; p 0.000). Conclusion: the prevalence of the syndrome was low and was associated with the time and number of daily hours dedicated to the care, elderly dependency and family dysfunction

Introduction: the physiological process of aging, combined with biological, genetic, habits, lifestyle, chronic diseases, and psychosocial factors, leads to the development of a fragile older adult, so it is important to study the related factors. Objective: To determine the family functionality and factors associated with frailty syndrome in the elderly in the community of Cebollar, Cuenca 2015. Material and methods: a cross-sectional quantitative study was carried out on 205 elderly Cebollar adults. A data collection instrument was used to know sociodemographic characteristics. Family function was evaluated using the FFSIL test and the fragility syndrome using the Fried criteria. The variables were represented as absolute frequencies and percentage. Chi square test, relative risk (RR) and 95% confidence intervals were used to determine the association between variables. Results: the prevalence of fragility syndrome in the elderly was 55%. The following factors were significantly associated with frailty: age> 80 years (RR=2.67, 95%CI: 2.05-3.46, p<0.001); Widowhood (RR=1.51, 95%CI:1.21-1.90, p=0.001); Polypharmacy (RR=2.23, 95%CI:1.82-2.73, p<0.001); Hospitalization (RR= 2.04, 95%CI:1.76-2.37, p<0.001); Comorbidity (RR=1.93, 95%CI:1.63-2.28, p<0.001); And social dysfunction (RR= 3.70, 95%CI:1.77-7.74, p<0.001) and family dysfunction (RR=1.59, 95%CI:1.28-1.98, p<0.001). Conclusions: A high prevalence of prefragility and fragility was obtained in the elderly population; which had association with age over 80 years, widowhood, polypharmacy, hospitalization in the last 12 months, comorbidity, depression, social risk and family dysfunction

Background. Abdominal wall hernias are still suffering more frequent in both sexes and his treatment represents the highest percentage of elective surgery. Objective. Determine the frequency of hernias abdominals and surgery treatment in patients attended in the Hospital of the III Division Tarqui of Cuenca, in the period 1994 to 2015. Material and methods. He was a compilation retrospective of 446 clinical histories of patients. Is analyzed the distribution of the herniated abdominal according to: age, sex, State nutritional, type of user, type of hernia and treatment surgical employed. Results. The mean of age was of 38.9 ± 15.3 years. Those men were the 66.8% of the shows. They found overweight in the 17.5% and 2% between obesity types I and II. Those users civilians were the 55.4% and the military the 23.8%. The inguinal hernia (57.2%) was more frequent in the sample. In adults young them hernias umbilical (66.9%) and epigastric (20.3%), were the more frequent; in those adults mature it were: inguinal (52.3%), umbilical (17.1%) e incision (14.1). The militaries the hernias more frequent were inguinals. The herniorrhaphy was treatment in 66.8% of the patients, the hernioplasty in the 30.2% and those procedures laparoscopic is used in the 2.6%. The mesh is used in the 31.5% of patients. Discussion: the results of our series were similar to those reported by the sources consulted

Introduction: Couple violence against women is a public and family health problem, it must be studied due to physical, psychological and social consequences that affect the health and quality of life of women, and the family, however, in the Parish of Guel there are no previous studies on this situation. Objective: To determine the characteristics of violence of the couple against the woman and the relation with the familiar functionality in the parish Güel of the Canton Sigsig. Material and methods: A cross-sectional study was carried out in 113 women from the Güel parish of Sigsig Canton, from 2015-2016. A data collection instrument was applied to know the socio-demographic characteristics, the family functionality was evaluated by the FFSIL test and the partner violence through the WAST test. The variables were represented as absolute frequencies and percentage. The chi-square test, prevalence ratio (PR), and 95% confidence intervals were used to determine the association between variables. Results: The prevalence of partner violence was 25.7%. The women with more partner violence were those of more than or equal to 46 years (PR = 2,743, 95% CI: 1.485-5.087, p = 0.001), unstable partner (PR = 3.023, 95% CI: 1.718-5.321, p <0.001 ), Family absence (PR = 4.612, 95% CI: 2.795-7.610, p <0.001) and family dysfunction (PR = 17,200, 95% CI: 2,427-121,885, p <0.001). Conclusions. Partner violence was found associated with family dysfunction and unstable couples with low schooling and few support networks

Introduction: malnutrition in the elderly is a major concern worldwide. It is a public health problem and it is associated with a number of factors, some of them are modifiable. Objective: to determine the prevalence and factors associated with malnutrition in older adults in Gualaceo town, 2016. Methodology: an analytical cross-sectional study. Sampling was probabilistic, stratified and randomized, which assessed 250 elderly. Nutritional status was assessed using the Mini Nutritional Assessment (MNA). Data were tabulated in SPSS version 20.0. Characterization of the population was performed through descriptive statistics and central trend measures, statistical association was measured with prevalence ratio (RP), 95% confidence interval (IC) and values of p <0.05 were considered statistically significant. In addition, a multivariate analysis was performed. Results: the prevalence of malnutrition was 20,4%. The average age 76,31 (± 8,19). The associated factors were: depression RP 4,90 (95% CI: 3,08 – 7,79, p< 0,000); sedentary lifestyle RP 4,52 (95% CI: 2,81 – 7,28, p <0,000); low socioeconomic level RP 4,04 (95% CI: 1,51 – 10,7, p<0,001); anemia for both men and women RP 2,43 (95% CI: 1,23 – 4,77, p<0,018) and RP 4,02 (95% CI: 2,17 – 7,63, p<0,000) respectively and hypoalbuminemia RP 2,87 (95% CI: 1,08 – 4,58, p<, 0,000). Multivariate analysis corroborated this association except for hypoalbuminemia. Conclusions: the prevalence of malnutrition was 20,4% and it is associated to: depression, sedentary lifestyle, low socioeconomic status, anemia and hypoalbuminemia

background: hypothyroidism is associated with cardiovascular diseases, however, studies that demonstrate the association with metabolic syndrome reveal different results. Objectives: To determine the prevalence of clinical and clinical sub hypothyroidism and its association with the metabolic syndrome in people between 40-65 years of age, who go to outpatient clinic at the Pablo Jaramillo Foundation in the city of Cuenca during 2016. Materials and methods: A cross-sectional study was carried out. 256 patients were included, according to a 10% expected frequency, with a 95% confidence level, and a margin of error of 4%, whom attended the Pablo Jaramillo Foundation in Cuenca. Clinical, anthropometric and laboratory assessment (TSH, glucose, HDL and triglyceride levels) were performed. The components of the Metabolic Syndrome were graded according to the ALAD / GLESMO / IDF harmonized criteria. Results: the study group consisted of 79.3% of female patients. The prevalence of hypothyroidism was 37.8% with a 95% CI 31.7-44, with the most frequent subclinical presentation being 31%. The association between hypothyroidism and metabolic syndrome was established by obtaining an RP of 2.5; with a 95% CI 1.30-3.57; (P <0.02). From the criteria of the metabolic syndrome, a statistically significant association was found between hypothyroid patients and those with triglyceride values >150mg / dl with a PR of 1.26 and 95% CI 1.05-1.51; (P <0.01). Conclusions: the prevalence of the two pathologies is higher than expected; Hypothyroidism is associated with the metabolic syndrome

INTRODUCTION: Health problems derived from the changes in seniors are falls, the prevalence of falls in healthy seniors oscillate from 15-30%. The etiology is multifactorial; there have been identified conditions and precipitating factors. OBJECTIVE : To determine the prevalence of falls in seniors and associated factors intrinsic: chronic diseases, mental status, ambulation; extrinsic: drugs, alcohol, shoes, daily activities, location, condition of the floor , day interval, and not classifiable: previous falls, fear of falling , types of falls, in the Parish Sidcay, Canton Cuenca. METHODOLOGY: This was a cross-sectional study, the population was established in the seniors of the Parish Sidcay. We worked with 489 seniors. For the recollection of data we used a questionnaire based on the WHO and the “Risk Scale Dowton Falls”, the data were tabulated and analyzed using SPSS 15.0, for demographic variables we used the percentage, frequency, and measures of central tendency, to find association prevalence ratio with confidence interval of 95% and for statistical significance with the chi-square p value. RESULTS: The prevalence of falls was 33.9%. Had a higher prevalence of falls patients > 74 years (43.1 %), female (40.9%), without partner (45.1 %) and the patients with nutritional disorders (64.8%). The risk of falling according to the Dawton scale was: high risk 32.1% and low risk 67.9%. It was associated with:> 74 years RP1.84 (1.4 to 2.42), female RP1.65 (1.25 to 2.17), living without partner RP1.73 (1.35 to 2.22) , chronic diseases RP1.62 (1.23 to 2.13), confused mental state RP2.10 (1.37 to 3.22), unsafe ambulation with or without help RP2.31 (1.8-2.9), drug consumption RP 1.29 (1.01 to 2.15), walking barefoot RP3 (2.5-3.5) and previous falls in all cases p <0.05. CONCLUSIONS: As reviewed there is a population of older adults at risk either high or low falls, this implies the need to integrate the care of this population safe environment like homes, to suit the us

Introduction: Worldwide, the elderly population increases, Ecuador does not remain outside this demographic transition and thus also increase all diseases associated with aging, mainly hypertension. Objective: To determine the prevalence of hypertension in adults over urban parishes in the city of Cuenca, 2015. Methodology: A descriptive study was conducted on a sample of 378 older adults. Were hypertensive patients with two separate measuring blood pressure at least one week in which systolic blood pressure is> or = 140 mmHg and diastolic blood pressure> or = 90 mmHg. It was classified according to sociodemographic parameters, family history, nutritional status and physical activity. The sampling was of census areas in each parish, a simple random sampling was used. The data were analyzed in SPSS version 15.0, using frequency distribution, measures of central tendency: mean and dispersion measures: standard diverted. Results: The frequency of hypertension was 52.5%. 65.1% of hypertensive patients were women and 34.9% men. 57.6% of hypertensives were were between 65 and 74 years. 41.2% had completed primary school. 76.4% had no occupation. 51.2% had no family history of hypertension. 40% performed moderate physical activity. 41.9% were obese. Conclusion: The frequency of hypertension in adults older urban parishes in the city of Cuenca was 52.5%

This article presents a brief review of what has been education in Ecuador, and specifically in the health area, beginning with different tendencies of medical education and its advance in different parts of the world, starting with the scientific approach, through the problem-based approach and ending with systemic approach and how new technologies have been introduced in health education. Then, some basics presented in the use of new technologies in health education worldwide and what is the experience with Clinical Simulation in the University of Cuenca. Finally, it is concluded that clinical simulation is a very useful method in the Health Sciences as a tool for educational purposes that accelerates the teaching-learning process of students who express personal satisfaction with this experience, they value the integration of theory with practice nd they prioritize the action in an organized way.

INTRODUCTION: Metabolic syndrome is a cause of morbidity and mortality worldwide, the likelihood of developing complications such as diabetes, kidney disease take it that where serum urea and creatinine will be elevated. OBJECTIVE: Determine the prevalence of alterations serum urea and creatinine in mayors adult with and without metabolic syndrome on urban parishes of canton Cuenca, 2016. METHODOLOGY: Descriptive study on 378 patients higher 65 years old, wich lives in Cuenca`s canton, data were obtained by surveys that included personal data, informed consent was requested, anthropometric measures were taken; for colorimetric quantification of urea and creatinine serum of all patients she was analyzed in the Diagnostic Center of the Faculty of Medical Sciences. For data processing SPSS, Epi Info and Excel was used. RESULTS: Clinical examinations indicated that 1.25% male patients had levels greater than 50 mg/dl urea, others had normal values (10-50mg/dl). In the case of women it indicated that 2.4% had levels higher than normal value of urea and other women reported normal values. In the case of creatinine, they indicated 31.3% males have normal values (0.7-1.3mg/dL); 3.6% had low values (<0.7mg/dl) and 1.6% exhibited high (> 1.3mg/dl). Meanwhile 47.8% of women had normal levels of creatinine (0.6-1.1mg/dl); 8.0% had low values (<0.6mg/dl) and 7.8% showed values greater than 1.1mg / dl

A marked increase in the population aged 60 years and over is evident; the proportion of the older adult population will rise 18.6% in 2025. On the other hand, obesity, metabolic syndrome (MS), diabetes and insulin resistance (or low insulin sensitivity-IS) are diseases related to lifestyle, they have become a social and public health problem. IS is the ability of cells to react due to insulin's presence; when this ability is diminished, low insulin sensitivity or insulin resistance (IR) is considered. Studies show that IS decreases with age, though no one knows exactly if it is directly due to aging or changes in muscle mass. IS can be determined using direct or indirect methods. This paper aims to propose an insulin sensitivity method design from anthropometries and lipid measures. The methodology consist in a simple correspondence analysis for determine the variables, and a parametrical optimization using Avignon method as optimal function. The database used is composed by 120 Ecuadorian older adults with and without MS. The results show that the proposed optimized method got a better correlation with Avignon compared to non-optimized method. The proposed method could discriminate between subjects with and without IR and with and without MS. This is an important contribution since other methods like HOMA-IR, which is the most used in clinical practice, cannot find these differences, this means that HOMA-IR is not sensitive for IS estimation in elderly people. Future works will focus in the determination of cutoffs for insulin resistance diagnosis in the proposed method.

Introduction: It is necessary to assess the sensitivity to insulin in their early stages in that way, it will be avoided to suffer from illnesses like diabetes type 2; among elderly people, changes, such as the increase of adipose tissue and the sarcopenia are present. Those have a relationship with the decrease of sensitivity to insulin. Objective: To determine the sensitivity to insulin through the oral tolerance test among elderly people from the city of Cuenca in 2015. Methodology: It is a descriptive research. The participants are 120 elderly people from Cuenca; 60 cases with metabolic syndrome according to the ATP III criterion and 60 cases without metabolic syndrome. This is about a non-probabilistic sample by convenience. Two blood samples were taken. One before post prandial glucose and insulin were dosified. The data collected was analyzed through SPSS 22, Excel using frequencies, percentages and measurements of central tendency, such as median, mean, dispersion measurements, standard deviation. Results: The 39.2% of elderly people showed an alteration of the insulinemic post prandial. According to the HOMA-IR method, the 42% has a low sensitivity to insulin and the QUICKI method shows that the 91.7% has a decreased sensitivity to insuline. The low sensitivity to insuline related to gender, age and marital status was not significant; in contrast, the change with the BMI alterated has more probability to suffer insuline resistance. (p=0.03). Being more significant patients with metabolic syndrome; it increases two times the probability of suffering insuline resistance. (p=0.02, OR 2.3 IC 95% 1.09 – 4.85)

Introduction: The dyslipidemias are a set of nutritional and genetic alterations associated with cardiovascular disease, prevailing and increase morbidity and mortality. Its importance in the elderly is its high frequency causing serious complications both physical and psychological. In Ecuador the percentage of dyslipidemia is 17.6%, being the main hypertriglyceridemia with 40.6% for that reason has become one of the leading causes of daily outpatient. Objective: To determine the frequency of dyslipidemia by clinical diagnosis in adults over urban parishes of the canton Cuenca. 2015 Materials and Methods: It is about descriptive studies which were performed. We got data on age, sex, occupation, marital status, education, and history of chronic no communicable diseases; and through surveys we also get anthropometric measures such as height, weight, and abdominal circumference. A sample of venous blood was drawn and a lipid profile to all participants was conducted, the data were tabulated and analyzed using the SPSS, Epi Info and EXCEL programs for data analysis descriptive statistics was applied to frequency, percentages. Results: The percentage of dyslipidemia was 20.7 %, hypertriglyceridemia 14,2%, hypercholesterolemia was 6,5%, in females was 15,0% and males 7,0%, dyslipidemia prevalent among 65 to 74 to 15.5 % , likewise, 7.8% of older adults have no education , 12.1 % were married , 13.7 % are passive.An association with dyslipidemia to passive persons, with no education.