Frailty associated with nutritional status, functionality, physical activity and socioeconomic level, in older adults in Ecuador, post-pandemic

Aging is a complex, multifactorial process in which nutritional alterations, sedentary lifestyle, and chronic diseases can increase the risk of functional limitations, dependence, and disability in older adults. Identifying the degree of frailty is essential for designing programs to enhance their quality of life. The objective of the study was to determine the prevalence of frailty and its association with nutritional status, functionality, physical activity, and socioeconomic level in older adults in Azuay, a province in Ecuador, during post-pandemic period of 2023. A cross-sectional study was conducted with 294 older adults from Azuay Anthropometric measurements were taken, and validated questionnaires were administered to collect demographic data. Frailty was assessed using criteria validated by Fried and Watson. The Katz Index was employed to determine the level of dependency, physical activity was assessed using the short version of IPAQ, and socioeconomic level was determined according to the Ecuadorian Institute of Statistics and Censuses (INEC). Data were analyzed using SPSS version 26.0, employing frequency distribution, measures of central tendency (mean) and dispersion (standard deviation). Odds Ratio (OR) with a 95% confidence interval to explore associations. The mean age was 74.1 years (± 7.1), with a higher prevalence between 65 and 74 years (52.4%). Women represented 72.1% of the sample, nearly half were married, 67.7% had completed primary education, and over a quarter were engaged in household work. According to BMI, women showed a higher prevalence of overweight and obesity, along with greater abdominal obesity. Both sexes reported moderate levels of physical activity. The prevalence of frailty in women was higher than in men (10.4% vs. 4.9%) and was significantly associated with physical inactivity (OR = 1.634, 95% CI 1.458–1.817; p < 0.001) and low socioeconomic level (OR = 2.176, 95% CI 1.027–4.608; p < 0.039). Frailty prevalence was high among older adults and was significantly associated with low physical activity and low socioeconomic status. These findings highlight critical challenges for Ecuador's public and private healthcare systems in implementing proactive measures to delay the onset of frailty and improve quality of life in this population.