https://doi.org/10.37955/cs.v8i2.346

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Promotion and control of chronic

non-communicable diseases in

older adults: A Bibliographical

Review

Promoción y control de enfermedades crónicas no

transmisibles en los adultos mayores: Una Revisión

Bibliográfica

Angel Antonio Palomino Castillo

Msc. Instituto Superior Tecnológico Universitario Espíritu Santo,

https://orcid.org/0009-0007-1213-5518

appalomino@tes.edu.ec

ABSTRACT

The article responded to a result related to the theoretical

underpinnings on: health promotion and control of Chronic Non-

Communicable Diseases in older adults corresponding to the research

project "Promotion and control of Chronic Non-Communicable

Diseases in older adults of the Clemencia Foundation and the Sofia

Ratinoff Asylum in the city of Guayaquil". The promotion and control

of chronic non-communicable diseases (NCDs) in older adults is

fundamental to improve their quality of life and reduce the burden of

disease in this population. NCDs, such as diabetes, hypertension,

cardiovascular and respiratory diseases, represent a growing challenge

in the aging population. Health promotion includes education on

healthy lifestyles, such as a balanced diet and regular exercise, as well

as prevention of smoking and excessive alcohol consumption. Effective

control of NCDs involves comprehensive medical care, which may

include regular blood pressure monitoring, blood glucose control, and

appropriate administration of medications. The implementation of

NCD promotion and control programs in older adults requires

Centro Sur Vol. 8 No. 2- April – June - Revista Centro Sur - eISSN: 2600-5743

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

interdisciplinary coordination and a patient-centered approach, with

the aim of improving health and well-being at this stage of life. The

research is of the documentary type by addressing a theoretical

framework, with a qualitative approach. Theoretical methods used

were: analysis and synthesis, induction and deduction from abstract to

concrete and descriptive.

RESUMEN

El artículo respondió a un resultado relativo a los sustentos teóricos

sobre: promoción de la salud y el control de Enfermedades Crónicas

no Transmisibles en los adultos mayores correspondiente al proyecto

de investigación “Promoción y control de Enfermedades Crónicas no

Transmisibles en los adultos mayores de la Fundación Clemencia y el

Asilo Sofia Ratinoff de la Ciudad de Guayaquil”. La promoción y

control de enfermedades crónicas no transmisibles (ECNT) en adultos

mayores es fundamental para mejorar su calidad de vida y reducir la

carga de enfermedad en esta población. Las ECNT, como la diabetes,

hipertensión, enfermedades cardiovasculares y respiratorias,

representan un desafío creciente en el envejecimiento de la población.

La promoción de la salud incluye educación sobre estilos de vida

saludables, como una dieta equilibrada y ejercicio regular, así como la

prevención del tabaquismo y el consumo excesivo de alcohol. El

control efectivo de las ECNT implica una atención médica integral, que

puede incluir el monitoreo regular de la presión arterial, el control de

la glucosa en sangre y la administración adecuada de medicamentos.

La implementación de programas de promoción y control de ECNT en

adultos mayores requiere una coordinación interdisciplinaria y un

enfoque centrado en el paciente, con el objetivo de mejorar la salud y

el bienestar en esta etapa de la vida. La investigación es de tipo

documental al abordar un marco teórico, con un enfoque cualitativo.

Se usaron métodos teóricos como: el análisis y síntesis, la inducción y

deducción de lo abstracto a lo concreto y el descriptivo.

Keywords / Palabras clave

Older Adults, Chronic Non-Communicable Diseases, Health

Promotion, Disease Control, Integrated Health Care

Adultos Mayores, Enfermedades Crónicas No Transmisibles,

Promoción de la Salud, Control de Enfermedades, Atención Médica

Integral

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

Introduction

The aging of the population is a global phenomenon that has led to a

significant increase in the prevalence of chronic noncommunicable

diseases (NCDs). These diseases, which include diabetes mellitus,

arterial hypertension, cardiovascular diseases, among others,

represent a considerable burden for health systems and affect the

quality of life of older adults.

According to the World Health Organization (2022), health promotion

is a process that provides the population with the means to exercise

greater control over their own health and improve it; in the case of

older adults, it is important to provide them with adequate health

promotion and prevention activities, considering their longer life

expectancy and the need to maintain their autonomy and prevent

diseases.

Despite the availability of effective treatments for many chronic

noncommunicable diseases, significant barriers to health care access

and treatment adherence still persist in older adults, so it is important

to investigate how health promotion and disease management

interventions can be tailored to meet the specific needs of each

vulnerable group or individual.

This study provides a solid basis for the design of public health policies

and intervention programs that effectively address the health needs of

older adults with chronic noncommunicable diseases. The objective of

this study is to analyze the existing literature on health promotion and

control of chronic noncommunicable diseases, through this analysis,

we seek to evaluate the effectiveness of health promotion interventions

and control strategies specifically targeted to this population. In

addition, the aim is to identify associated risk factors, as well as to

detect possible gaps in current knowledge that may guide future

research.

Health promotion is fundamental to prevent diseases and improve

quality of life. It is a dynamic process that involves the acquisition of

health knowledge, skills and abilities at both the individual and

collective levels (Meras & Rodríguez, 2021). The World Health

Organization (2022) defines it as a means for people to have greater

control over the factors that influence their health, resulting in overall

health improvement. It is a process that encompasses social and

political aspects, seeking to strengthen individual capacities and

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

modify social, economic and environmental conditions to reduce the

negative impact on health at both the individual and community levels.

In the specific context, the Ministry of Public Health of Ecuador (2022)

expands this definition, considering integral and specific aspects of

Ecuadorian society. Health promotion here is understood as a

comprehensive process that seeks to strengthen people's capacity to

improve their health, taking into account cultural, social,

environmental and economic factors. Special attention is given to

gender, cultural and ethnic differences, as well as to the different life

stages of individuals and communities. In summary, health promotion

in Ecuador seeks not only to improve individual health, but also to

address the inequities and social challenges that affect public health in

general.

The promotion and control of chronic noncommunicable diseases in

older adults is a crucial public health priority due to the increase in life

expectancy and the prevalence of these diseases in this population.

First, it is essential to implement health promotion programs that

promote healthy lifestyles in older adults, including a balanced diet,

the regular practice of physical exercise appropriate to their abilities,

and the abandonment of harmful habits such as smoking and excessive

alcohol consumption (De La Guardia & Ruvalcaba, 2020).

In addition, it is essential to establish systems for early detection and

early diagnosis of chronic diseases in this population. This implies

performing regular medical checkups that include the measurement of

parameters such as blood glucose, blood pressure and body mass

index, which allows identifying risk factors and diseases in early stages

in order to intervene in a timely manner (Serra, 2020).

Another crucial aspect is to ensure equitable access to specialized

health care services and medications for the treatment and control of

chronic diseases in older adults. This includes the availability of

regular medical consultations, essential medicines, as well as

education and ongoing support for self-care and adherence to

treatment (Tamayo, 2019).

In addition, secondary and tertiary prevention strategies should be

promoted to reduce the impact of chronic diseases already established

in older adults. This implies the implementation of rehabilitation

programs, comprehensive management of chronic diseases and

palliative care, in order to improve quality of life and reduce

morbimortality associated with these diseases (Iza & Saavedra, 2023).

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

Health and aging

Health is defined as an optimal state of adaptation, growth and

development, while disease represents a rupture in this adaptation or

a crisis of the human body when trying to maintain its adaptive

balance, that is why health promotion is fundamental to build a

healthier world, since it implies promoting healthy lifestyles and

reducing the factors that predispose to disease (Flores & Aceituno,

2021).

For its part, population aging is a global phenomenon that is impacting

all countries across the board and these people are in a phase of life in

which they experience a series of physical and psychological changes

that can influence their quality of life, therefore, they need specialized

care to ensure their well-being and prevent the deterioration of their

health (Maggi & Llanos, 2022).

One of the main challenges associated with population aging is the

increase in chronic diseases and physical and cognitive disabilities. As

people age, the risk of developing multiple conditions increases, which

can have a significant impact on individuals' quality of life and

represent a considerable burden on health care systems (Vizcaino et

al., 2021).

In addition to health challenges, population aging also raises

important social and economic considerations. For example, the

increase in the older population may put pressure on pension and

social security systems, as well as on health care and long-term care

services (Forttes, 2020). It may also affect family and community

structure, as more older people may require support and care from

their families and communities (Robledo et al., 2022).

Health promotion in older adults.

It is essential that older people are considered as active participants in

the development process and that they can enjoy the benefits it

generates (Saraiva & Salmazo, 2022). Development refers not only to

a country's ability to increase its production of goods and services with

high efficiency, but also to ensure that all citizens have equitable access

to these resources and to create conditions that foster personal growth

in a safe and dignified environment (Alvarez et al., 2019).

The primary objective of health promotion in older adults is to

improve their quality of life by preventing or delaying diseases and

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

their consequences. Therefore, it is crucial to foster dynamic,

collaborative and reflective educational spaces where older adults can

share their knowledge and experiences (Pola et al., 2021). Likewise, it

is essential to work on health promotion with families and caregivers

of older adults to create safe, welcoming and stimulating

environments. It is essential to identify and implement care strategies

for older adults, making it clear that this responsibility is shared by all

members of society (Troncoso et al., 2020).

Promotion of chronic noncommunicable diseases

The author Morla, (2020) emphasizes that recently, the control of

chronic noncommunicable diseases has gained considerable

importance, since the need to pay greater attention to these diseases

has become evident, given that their incidence and prevalence

significantly affect the quality of life and, therefore, social

development. Araújo et al. (2022) consider that the term

"noncommunicable diseases" refers to a set of conditions that are not

primarily caused by acute infections, but result in long-term health

consequences, often requiring ongoing treatment and care. These

conditions encompass diseases such as cancer, cardiovascular disease,

diabetes and chronic lung disease.

According to Soria et al., (2020) chronic noncommunicable diseases

are conditions of uncertain origin and multiple causes, with prolonged

incubation and latency periods, as well as extensive subclinical phases

and frequent clinical episodes. They are characterized by a prolonged

clinical course and lack specific treatment or spontaneous resolution

over time. In addition, their etiology is not fully demonstrated, except

in some types of cancer, and they have a great impact on the adult

population.

These diseases, which are of long duration and with a generally slow

evolution, represent a growing epidemic, partly due to the aging of the

population and contemporary lifestyles that encourage sedentary

lifestyles and poor nutrition (Shikha et al., 2023). This practice

involves a range of strategies and activities that aim to prevent disease,

promote healthy lifestyles, and create environments that support

health in all aspects. Health promotion encompasses a wide range of

areas, such as health education, promotion of physical activity, proper

nutrition, stress management, prevention of harmful substance use,

among others (Canuto et al., 2021).

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

Chronic noncommunicable diseases are a set of long-lasting and

slowly progressive conditions that are responsible for a large burden

of morbidity and mortality worldwide, especially in the older adult

population. These diseases include conditions such as type 2 diabetes,

cardiovascular disease, chronic obstructive pulmonary disease

(COPD), cancer, and mental and behavioral disorders associated with

aging, among others (Nittas et al., 2019)

Inadequate lifestyle

Lifestyle is closely related to the development of chronic

noncommunicable diseases, i.e. having inadequate lifestyles makes

you more vulnerable to suffer from these diseases that are long-lasting

and generally progress slowly (Suarez et al., 2020). There are some

ways in which an unhealthy lifestyle can contribute to the development

of chronic noncommunicable diseases, which include:

Unhealthy diet: consuming foods that contain high amounts of

saturated fats, refined sugars, and sodium, along with insufficient

intake of fruits, vegetables, and whole grains, can increase the risk of

cardiovascular disease, type 2 diabetes, and certain types of cancer. In

particular, a diet rich in saturated and trans fats can raise LDL

cholesterol levels in the blood, which promotes the formation of plaque

in the arteries and increases the possibility of blockages, thus

increasing the risk of cardiovascular disease (Riquelme, 2022).

Excess refined sugars, commonly present in sugary drinks, sweets and

bakery products, can cause blood glucose spikes followed by steep

drops, contributing to insulin resistance and increasing the risk of

developing type 2 diabetes. In addition, a diet low in fruits and

vegetables deprives the body of important vitamins, minerals, fiber

and antioxidants needed to maintain a strong immune system and

protect against chronic diseases, such as cardiovascular disease and

certain types of cancer (Betivegna & Marquez, 2020).

Excess dietary sodium, commonly present in processed and fast foods,

can raise blood pressure and increase the risk of cardiovascular

diseases, such as hypertension and stroke. Likewise, a diet low in fiber

can contribute to digestive problems such as constipation,

diverticulitis, and colorectal cancer, as fiber is crucial for maintaining

a healthy and regular digestive system (Gonzalez et al., 2022).

Lack of physical activity: Lack of physical activity is a determining

factor in the development of chronic noncommunicable diseases and

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

can have a significant impact on a person's overall health. First,

physical inactivity is associated with an increased risk of obesity. When

not exercising regularly, excess calories are stored as fat, which can

lead to weight gain and obesity, a major risk factor for chronic diseases

such as type 2 diabetes, cardiovascular disease, and certain types of

cancer (Muñoz et al., 2018).

Regular exercise helps strengthen the heart and blood vessels,

improves blood circulation, and lowers blood pressure. It has been

shown to reduce stress, anxiety, and depression, as well as improve

mood and sleep quality. Physical inactivity, in contrast, can increase

the risk of mood disorders and worsen overall mental health (Teixeira

et al., 2020).

Tobacco and alcohol consumption: Tobacco and alcohol consumption

are two habits that are closely related to the development of chronic

noncommunicable diseases. Smoking is one of the main risk factors

for a variety of chronic diseases, including cardiovascular diseases,

chronic respiratory diseases such as chronic obstructive pulmonary

disease (COPD), and several types of cancer, such as cancer of the lung,

mouth, throat, esophagus, bladder, and pancreas. Toxic chemicals

present in tobacco smoke damage body tissues and can cause genetic

mutations that lead to the development of cancer cells (Garcia et al.,

2021).

On the other hand, excessive alcohol consumption can increase blood

pressure, damage the liver and increase the risk of liver diseases such

as cirrhosis. In addition, it can contribute to the development of

cardiovascular diseases, increase the risk of stroke, pancreatitis, and

mental disorders such as depression and anxiety (Herrera, 2022).

Chronic stress is a condition in which a person experiences elevated

levels of stress on a constant or recurrent basis over a prolonged period

of time. First, it can negatively affect the cardiovascular system. The

body reacts to stress by releasing hormones such as cortisol and

adrenaline, which increase blood pressure and heart rate. In addition,

chronic stress can affect the immune system, weakening the body's

ability to fight disease and infection (Méndez & Sinarahua, 2022).

Inadequate rest lack of adequate sleep can negatively affect cognitive

functioning. During sleep, the brain processes information,

consolidates memory, and restores cognitive functions. Sleep

deprivation can lead to difficulty concentrating, memory problems,

decreased cognitive performance and lack of mental clarity. Lack of

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

sleep can alter levels of hormones related to hunger and metabolism,

which can lead to increased appetite, increased intake of unhealthy

foods and weight regulation problems (Cepero et al., 2020).

Socioeconomic factors: An individual's socioeconomic status

influences his or her access to critical resources such as health care,

education, employment, and housing. Those with low socioeconomic

status may face difficulties in accessing nutritious foods, preventive

health services, and exercise activities, increasing their vulnerability to

chronic diseases. Those with lower incomes may face financial

difficulties in accessing quality health services, which may result in

poor detection and treatment of chronic diseases (Geri et al., 2023).

Genetic factors and family predisposition: Individuals with a family

history of certain chronic diseases may be at increased risk of

developing those same conditions due to a combination of shared

genetic and environmental factors in the family. For example, if a close

relative has a history of heart disease, other family members may also

have an increased risk of developing cardiovascular disease due to

shared genetic factors and behaviors (Castro et al., 2022).

Materials and Methods

The research focused on the promotion and control of chronic

noncommunicable diseases in older adults. Through a qualitative

approach of documentary type of bibliographic review, relevant

information was collected from various sources to understand in depth

the factors related to these diseases in this specific population. The

type of research, bibliographic, allowed reviewing and analyzing

previous studies on chronic noncommunicable diseases in older

adults, which provides an overview of existing findings and strategies

for health promotion and disease control in this population.

The theoretical methods used such as: analysis and synthesis,

induction and deduction from abstract to concrete and descriptive

allowed to examine the theories and concepts related to chronic

diseases in older adults, also to review provide concrete evidence on

effective interventions and practices to promote health and control

these diseases in this population.

Regarding the population and sample, all relevant literature on the

topic was considered, including specific studies that address the

promotion and control of chronic noncommunicable diseases in older

adults, which included 53 articles of interest. For the sample that made

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

up the article, 45 articles were selected that covered the relevance of

the topic.

The research interventions included careful selection of relevant

literature sources, critical review of studies, and synthesis of findings

to identify effective strategies for health promotion and disease control

in older adults. In this context, the research instruments included

systematic literature search and selection of studies that specifically

addressed the topic of interest, thus providing a solid basis for the

formulation of recommendations and policies in the field of health of

older adults in relation to chronic noncommunicable diseases.

Results

For the analysis of the results, articles from various academic journals

and scientific sources were taken into consideration. These articles

include studies published in journals such as Población y Salud en

Mesoamérica, Enfermería Global, Revista Venezolana de Salud

Pública, Revista Confluencia, among others.

These sources provide a diversity of perspectives and approaches on

topics related to health, lifestyle, pharmacological adherence in older

adults, among other relevant aspects. By consulting these publications,

we have sought to obtain a comprehensive understanding of previous

research and the most recent findings in the field of public health and

medicine.

These articles, from a variety of academic journals, provide valuable

information to contextualize and support the analyses conducted in

this study. Being from reputable, peer-reviewed sources, the quality

and reliability of the data and conclusions presented in the analysis is

assured.

The author Tamayo (2019) considers that within non-communicable

diseases, cardiovascular diseases, such as acute myocardial infarction,

heart disease and stroke, has produced deaths to 17 million deaths

(48%) globally. In second place is cancer, which is responsible for 7.6

million deaths, followed by respiratory diseases such as asthma and

chronic obstructive pulmonary disease (COPD), which have produced

4.2 million deaths, and in third place diabetes mellitus, with a

condition of 1.3 million, with Europe and America being the regions

with the highest incidence of deaths.

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

(2023) mentions that with the increase in life expectancy and the

consequent growth of the population aged 60 years and older, the

proportion of people suffering from chronic noncommunicable

diseases is also increasing. A study was conducted with 300 older

adults, where arterial hypertension was the most common disease,

affecting 55% of the sample, followed by heart disease (32.3%) and

diabetes mellitus (18.3%). It was observed that hypertension was more

prevalent in men, while the other conditions predominated in women.

In the study by Vázquez et al. (2020), it is considered that the expected

behavior of birth rate, mortality and migration has led to high

morbidity rates for arterial hypertension, diabetes mellitus and

mortality from cancer and heart disease. Thus, an expected increase of

26.1% in morbidity from arterial hypertension, 34.1% in diabetes

mellitus, an increase of 56.2% in mortality from heart disease, and an

increase of 47.3% in mortality from cancer by 2030 in the population

aged 60 years and older is expected.

(2023) emphasizes that aging is a conditioning factor for the presence

of chronic noncommunicable diseases, the most common being

arterial hypertension and diabetes mellitus, which together with other

conditions or factors such as socioeconomic level and schooling, can

compromise the quality of life, in addition to directly influencing self-

care, most of which will require total dependence, which represents

economic expenses for the public system and the implementation of

strategies and actions for the control of chronic diseases.

Likewise, the author Pajuelo et al., (2022) conducted a study to

examine the prevalence of chronic noncommunicable diseases in older

adults showed that 75% of older adults within the factors presented

noncommunicable diseases in which arterial hypertension 36.3%,

metabolic syndrome 31% and hypertriglyceridemia (35.8%), among

others, were included. Men showed a lower frequency of obesity,

metabolic syndrome and dyslipidemia compared to women.

In a study carried out by Santana et al. (2020), teachers from

university institutions set out to investigate health promotion and

healthy lifestyles in Ecuador, with a focus on the context of higher

education institutions. Their objective was to identify and highlight the

fundamental aspects related to this topic. As a result, they concluded

that it is necessary to have teachers who possess adequate knowledge,

skills and methodologies to promote health and contribute to people's

wellbeing. In addition, they offered a series of suggestions and criteria

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

for developing actions and strategies that effectively promote health

and healthy lifestyles.

In a study conducted by Macías et al. (2023), chronic

noncommunicable diseases and their impact on quality of life in

Ecuador were investigated using a documentary and descriptive

approach. During the search for information, both original and review

articles were included, excluding those older than 10 years. The results

revealed that the main chronic noncommunicable diseases in Ecuador

are respiratory diseases (75%), arterial hypertension (63%) and type II

diabetes mellitus (38.5%). In addition, it was observed that quality of

life is significantly affected by the presence or development of these

diseases. It was concluded that chronic noncommunicable diseases are

prevalent in the Ecuadorian population and are usually associated

with various factors that influence their appearance.

Conclusions

Health promotion as a dynamic process that involves the acquisition

of health knowledge, skills and abilities at the individual and collective

levels. It is recognized that health promotion is essential for disease

prevention and improvement of quality of life, especially in vulnerable

population groups such as the elderly.

The aging of the population and the increase in chronic

noncommunicable diseases pose significant challenges in terms of

health care and wellness. It highlights the need to implement health

promotion strategies that address the risk factors associated with these

diseases, such as inadequate lifestyles, tobacco and alcohol

consumption, chronic stress, and lack of adequate sleep.

Health education programs aimed at older adults and their caregivers

emerge as key tools to promote wellness and quality of life in that

population. These programs not only provide practical advice on

adherence to treatment, proper diet and physical exercise, but also

foster the creation of social and emotional support networks that are

fundamental to the overall well-being of older adults.

Ultimately, the importance of a comprehensive and equitable

approach to health promotion, including equitable access to

preventive health care services and health education programs

tailored to the specific needs of older adults and their caregivers, is

emphasized.

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

References

Álvarez, C., Sánchez, B., Herrera, E., Villalobos, G., Vargas, J., &

Herrera, M. (2019). Análisis de sobrepeso y obesidad, niveles de

actividad física y autoestima en la niñez del II ciclo escolar del

cantón central de Heredia, Costa Rica. Población y Salud en

Mesoamérica. https://doi.org/10.15517/psm.v17i1.35323

Araújo, E., Tércio, T., Alves, I., de Assis, C., Rêgo, A., & Paiva, R.

(2022). Autocuidado de usuarios con enfermedades crónicas en

la atención primaria a la luz de la teoría de Orem. Enfermería

Global, 21(68), 172-215. https://doi.org/10.6018/eglobal.508511

Barrio, J., Suárez, C., Bandeira, M., Muñoz, C., Beca, M., Lozano, C., &

del Cura, I. (2020). Enfermedades crónicas en población

pediátrica: Comorbilidades y uso de servicios en atención

primaria. Anales de Pediatría, 93(3), 183-193.

https://doi.org/10.1016/j.anpedi.2019.12.019

Betivegna, G., & Marquez, A. (2020). Medicina del estilo de vida. Una

alternativa ante el avance de las enfermedades no trasmisibles.

Revista Venezolana de Salud Pública, 8(1), Article 1.

https://revistas.uclave.org/index.php/rvsp/article/view/2884

Brugere, D., Galarce, D., Gallegos, I., Hazín, C., & Rojas, J. (2020).

Nivel de adherencia farmacológica en adultos mayores de 60

años con patología HTA-DM: Una revisión bibliográfica. Revista

Confluencia, 3(2), 114-119.

https://revistas.udd.cl/index.php/confluencia/article/view/473

Canuto, K., Aromataris, E., Burgess, T., Davy, C., McKivett, A.,

Schwartzkopff, K., Canuto, K., Tufanaru, C., Lockwood, C., &

Brown, A. (2021). A scoping review of Aboriginal and Torres

Strait Islander health promotion programs focused on modifying

chronic disease risk factors. Health Promotion Journal of

Australia, 32(1), 46-74. https://doi.org/10.1002/hpja.307

Casanova, D., Raymond, G., & García, Y. (2020). Estrés, apoyo social

y representación de la enfermedad en pacientes con diabetes

mellitus. Revista Cubana de Endocrinología, 31(1).

http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S1561-

29532020000100009&lng=es&nrm=iso&tlng=es

Cepero, I., González, M., González, O., & Conde, T. (2020). Trastornos

del sueño en adulto mayor. Actualización diagnóstica y

terapéutica. MediSur, 18(1), 112-125.

https://www.medigraphic.com/cgi-

bin/new/resumen.cgi?IDARTICULO=99074

De La Guardia, M., & Ruvalcaba, J. (2020). La salud y sus

determinantes, promoción de la salud y educación sanitaria.

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

Journal of Negative and No Positive Results, 5(1), 81-90.

https://doi.org/10.19230/jonnpr.3215

Fernández, S., Cáceres, D., & Manrique, Y. (2020). Percepción del

apoyo social en adultos mayores pertenecientes a las

instituciones denominadas Centros de Vida. Diversitas:

Perspectivas en Psicología, 16(1), 55-64.

https://doi.org/10.15332/22563067.5541

Flores, B., & Aceituno, J. (2021). Planes de prevención de

enfermedades crónicas no transmisibles en niños y adolescentes.

Pediatría Atención Primaria, 23(90), 143-153.

https://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S113

9-76322021000200006&lng=es&nrm=iso&tlng=es

García, J., Moreno, A., & de la Cruz, E. (2021). Actividad física y estilo

de vida relacionado con la salud en la población española con

enfermedad musculoesquelética. Nutrición Hospitalaria, 38(1),

128-138. https://doi.org/10.20960/nh.02998

Geri, M., Gutiérrez, E., & González, G. (2023). Patrones alimentarios

de adultos mayores en una región argentina y su relación con

factores socioeconómicos. Revista de Salud Pública, 21, 581-587.

https://doi.org/10.15446/rsap.v21n6.82930

González, N., Vega, L., Gloria, L., Molina, V., & Malo, M. (2022).

Diseño de implementación del módulo de hábitos y estilos de

vida saludables de HEARTS en el primer nivel de atención en

México. Revista Panamericana de Salud Pública, 46, e200.

https://doi.org/10.26633/RPSP.2022.200

Guallo, M., Parreño, Á., & Chávez, J. (2022). Estilos de vida saludables

en adultos mayores. Revista Cubana de Reumatología, 24(4).

http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S1817-

59962022000400008&lng=es&nrm=iso&tlng=es

Herrera, L. (2022). Relación entre tabaquismo y las principales

enfermedades no transmisibles en El Salvador. Alerta, Revista

científica del Instituto Nacional de Salud, 5(1), 26-32.

https://doi.org/10.5377/alerta.v5i1.11753

Horta, L., Bautista, M., Ibáñez, E., Cobo, E., & García, A. (2022).

Calidad de vida y percepción de la salud en personas mayores con

enfermedad crónica. Revista Salud Bosque, 12(1), Article 1.

https://doi.org/10.18270/rsb.v12i1.3278

Maggi, W., & Llanos, E. (2022). Prevalencia de enfermedades crónicas

en adultos mayores atendidos en el área de consulta externa del

Hospital IESS Milagro. FACSALUD-UNEMI, 6(11), 125-134.

https://doi.org/10.29076/issn.2602-8360vol6iss11.2022pp125-

134p

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

Mena, E., Vega, M., & Córdova, W. (2022). Intervención educativa

para la preparación de los cuidadores del adulto mayor.

http://scielo.sld.cu/pdf/ric/v101n2/1028-9933-ric-101-02-

e3546.pdf

Méndez, E., & Sinarahua, Y. (2022). Estrés y enfermedades crónicas

en adultos en Latinoamérica: Una revisión narrativa [Maestría,

Universidad Peruana Unión].

https://repositorio.upeu.edu.pe/handle/20.500.12840/6020

Meras, R., & Rodríguez, G. (2021). Algunas consideraciones sobre

promoción de salud. Medicent Electrón., 25, 4.

http://scielo.sld.cu/pdf/mdc/v25n4/1029-3043-mdc-25-04-

658.pdf

Ministerio de Salud Pública de Ecuador. (2022). Funciones y acciones

de la subsecretaría nacional de promoción de la salud e

igualdad—2021 (Boletin-SNPSI-2021_07-02-2022).

https://www.salud.gob.ec/wp-

content/uploads/2022/02/Boletin-SNPSI-2021_07-02-

2022.pdf

Monterrey, M., Linares, L. B., Toledo, R., Vázquez, A., Rivera, D., &

Morales, C. (2021). Adherencia farmacológica y calidad de vida

relacionada con la salud en adultos mayores hipertensos. Revista

de Ciencias Médicas de Pinar del Río, 25(2).

http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S1561-

31942021000200011&lng=es&nrm=iso&tlng=pt

Morla, E. (2020). Las enfermedades crónicas no transmisibles.

Ciencia y Salud, 4(1), 3-3.

https://doi.org/10.22206/cysa.2020.v4i1.pp3-3

Muñoz, D., Arango, C., & Segura, Á. (2018). Entornos y actividad física

en enfermedades crónicas: Más allá de factores asociados.

Universidad y Salud, 20(2), 183-199.

https://doi.org/10.22267/rus.182002.122

Neves, T., Rêgo, A., Araújo, E., de Assis, C., Nóbrega, T., & Paiva, R.

(2023). Perfil clínico y sociodemográfico de usuarios con

enfermedades crónicas en atención primaria de salud.

Enfermería Global, 22(69), 245-282.

https://doi.org/10.6018/eglobal.512211

Organización Mundial de la Salud. (2022). Promoción del bienestar y

la salud (A75/10 Rev.1).

https://apps.who.int/gb/ebwha/pdf_files/WHA75/A75_R19-

sp.pdf

Pinilla, M., Ortiz, M., & Suárez, J. (2021). Adulto mayor:

Envejecimiento, discapacidad, cuidado y centros día. Revisión de

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

tema. Revista Salud Uninorte, 37(2), 488-505.

https://doi.org/10.14482/sun.37.2.618.971

Pola, E., Zuza, I., Gil, S., Justo, S., Campos, P., & López, A. (2021).

Promoción del envejecimiento saludable a través del abordaje de

la fragilidad. Revista Española de Salud Pública, 95.

https://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S113

5-57272021000100004&lng=es&nrm=iso&tlng=es

Polanco, S., Rivera, I., Salamanca, E., & Velasco, Z. (2021).

Características de salud y adherencia farmacoterapéutica en el

adulto mayor del municipio de Acacías (Colombia). Revista

Colombiana de Ciencias Químico - Farmacéuticas, 50(2), 325-

338. https://doi.org/10.15446/rcciquifa.v50n2.77677

Riquelme, R. (2022). Situación de estilo de vida y enfermedades no

transmisibles de trabajadores chilenos atendidos en mutual de

seguridad (Estudio Piloto). Revista de la Facultad de Medicina

Humana, 22(1), 154-161.

http://www.scielo.org.pe/scielo.php?script=sci_abstract&pid=

S2308-05312022000100154&lng=es&nrm=iso&tlng=es

Rodríguez, I. (2022). Estrategia comunitaria para desarrollar estilos

de vida saludables en adultos mayores. Revista Habanera de

Ciencias Médicas, 21(3).

http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S1729-

519X2022000300012&lng=es&nrm=iso&tlng=en

Santana, G., Gutiérrez, J., Sampedro, M., Toala, R., & Santana, I.

(2020). Criterios acerca de la promoción para la salud en el

contexto de la educación superior ecuatoriana. Polo del

Conocimiento: Revista científico - profesional, 5(10), 185-199.

https://dialnet.unirioja.es/servlet/articulo?codigo=7659402

Saraiva, R., & Salmazo, H. (2022). Qualidade da atenção à saúde do

idoso atenção primária: Uma revisão integrativa. Enfermería

Global, 21(1), 545-589. https://doi.org/10.6018/eglobal.444591

Serra, M. (2020). Non-communicable Chronic Diseases and the

COVID-19 Pandemic.

Shikha, D., Kushwaha, P., Gokdemir, O., Marzo, R., & Bhattacharya, S.

(2023). Editorial: Health literacy and disease prevention.

Frontiers in Public Health, 11.

https://www.frontiersin.org/journals/public-

health/articles/10.3389/fpubh.2023.1128257

Soria, A., Rodríguez, A., Medina, G., & Cabrera, M. (2020). Factores

de riesgo asociados a las enfermedades crónico-degenerativas no

transmisibles en los adultos mayores de la Parroquia

Quisapincha. Dilemas contemporáneos: Educación, Política y

Valores. https://doi.org/10.46377/dilemas.v33i1.2129

Received January 19, 2024/ Approved March 09, 2024 Pages: 63-79

eISSN: 2600-5743

Centro Sur Vol. 8 No. 1 – April – June

Suarez, M., Navarro, M., Caraballo, D., López, L., & Recalde, A. (2020).

Estilos de vida relacionados con factores de riesgo cardiovascular

en estudiantes Ciencias de la Salud. Ene, 14(3).

https://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S19

88-348X2020000300007&lng=es&nrm=iso&tlng=es

Taiano, V., Chalela, L., & Sánchez, P. (2020). Análisis de programas de

atención a personas adultas mayores a nivel internacional.

https://info.inclusion.gob.ec/phocadownloadpap/estudios/aten

cion_intergeneracional/2020/analisis_de_programas_de_aten

cion_a_personas_adultas_mayores_a_nivel_internacional.pdf

Tamayo, A. (2019). Prevención de enfermedades crónicas no

transmisibles: A propósito de una reflexión. Revista Finlay, 9(4),

243-245.

https://revfinlay.sld.cu/index.php/finlay/article/view/725

Teixeira, T., Brito, H., & Mattos, R. (2020). INACTIVIDAD FÍSICA,

ENFERMEDADES CRÓNICAS, INMUNIDAD Y COVID-19.

Revista Brasileira de Medicina do Esporte, 26, 378-381.

https://doi.org/10.1590/1517-8692202026052019_0040

Troncoso, C., Ximena Díaz, Martorell, M., Nazar, G., Cisternas, C., &

Cigarroa, I. (2020). Revisión de estrategias para promover el

envejecimiento activo en Iberoamérica Review of strategies to

promote active aging in Ibero-America.

Vargas, M. P., Rodríguez, M. C., Salgado M., C., Casallas, A. L., Vergel,

J., & Laverde R., D. (2023). Educación para la salud en

Enfermedades Crónicas No Transmisibles: Una revisión

sistemática. Revista de Educación en Ciencias de la Salud, 20(1),

8. https://dialnet.unirioja.es/servlet/articulo?codigo=8984677

Vázquez, E., Sánchez, I., Rodríguez, I., Feria, D., & Martínez, D.

(2020). Envejecimiento y morbimortalidad por enfermedades

crónicas seleccionadas en el municipio de Rafael Freyre,

Holguín, Cuba. Correo Científico Médico de Holguín, 24(4),

1031-1047. https://www.medigraphic.com/cgi-

bin/new/resumen.cgi?IDARTICULO=98390

Vizcaíno, G., Joza, M., Vizcaino, J., & Tauriz, W. (2021). El sistema

preventivo de enfermedades no transmisibles (SPENT) como

modelo innovador a aplicar en instituciones de salud pública:

The non-communicable diseases preventive system (SPENT) as

an innovative model to apply in public health institutions. South

Florida Journal of Development, 2(5), 6643-6660.

https://doi.org/10.46932/sfjdv2n5-024