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La relación entre el índice de masa corporal (IMC), la circunferencia de cintura (CC) y el deterioro cognitivo en adultos mayores no es consistente en la literatura internacional, y existe escasa evidencia en poblaciones rurales latinoamericanas. Determinar la asociación entre IMC, CC y función cognitiva en adultos mayores rurales de Cuenca, Ecuador, identificando los factores independientes del estado cognitivo. Estudio transversal en 316 adultos mayores (≥65 años) de parroquias rurales del cantón Cuenca. La función cognitiva se evaluó con el MMSE y la depresión con la escala Yesavage-15. Se calcularon correlaciones de Spearman y Pearson, y se construyeron modelos de regresión lineal múltiple ajustados. El 69.5% de los participantes presentó algún grado de compromiso cognitivo (puntaje MMSE medio: 22.7±7.0). El IMC y la CC no mostraron correlación significativa con el MMSE (rs=0.002, p=0.979 y rs=0.021, p=0.773, respectivamente). La depresión (Yesavage rs=−0.278; p<0.001) y la edad (rs=−0.225; p<0.001) fueron los factores más correlacionados con el MMSE. En el modelo de regresión ajustado (R²=0.214), el puntaje de depresión (β=−0.431; p<0.001), el sexo masculino (β=1.960; p=0.032) y el nivel educativo (β=2.381; p=0.003) fueron predictores independientes significativos; el IMC y la CC no alcanzaron significancia en ningún modelo. La función cognitiva en adultos mayores rurales de Cuenca no se asocia con la adiposidad corporal, sino con la depresión, la edad y el nivel educativo. Estos hallazgos subrayan la necesidad de intervenciones que aborden la salud mental y la educación como determinantes del envejecimiento cognitivo saludable.
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