Background/Objectives: Body mass index (BMI) trajectories and transitions across adulthood are dynamic processes influenced by aging and social- and health-related factors, yet long-term patterns in older adults from middle-income countries remain insufficiently characterized. The objective of this study was to characterize long-term BMI trajectories and transitions, and to identify sociodemographic and clinical factors associated with adverse BMI patterns among Mexican adults aged ≥50 years followed over 20 years. Methods: This study used data from the Mexican Health and Aging Study (ENASEM), a nationally representative longitudinal cohort. Participants aged ≥50 years with repeated BMI measurements across survey waves were included. BMI trajectories and transitions between BMI categories were described, and multinomial regression models were used to examine factors associated with upward transitions and unstable high-BMI patterns. Results: Distinct BMI trajectory patterns were identified over the 20-year follow-up. Participants in stable normal-weight trajectories were younger, more frequently female, and had higher educational attainment and income. In contrast, those with stable overweight/obesity or fluctuating–adverse BMI patterns had higher baseline BMI and a greater prevalence of diabetes, hypertension, and multimorbidity. In multivariable analyses, age contributed to trajectory differences; however, sex, socioeconomic factors, baseline BMI, and chronic conditions remained independently associated with adverse BMI patterns. Conclusions: BMI trajectories in later life are heterogeneous and reflect the combined influence of aging, socioeconomic conditions, and chronic disease burden. Identifying groups at risk of adverse BMI patterns may support the development of targeted interventions to reduce obesity-related health consequences in older adults.

Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a rapidly increasing global public health challenge. The objective was to analyze MASLD trends in Mexico by sex and state (1990-2023) and assess the association between the MASLD burden and the Socio-Demographic Index (SDI). Secondary analysis of Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2023 data (NAFLD definition, interpreted under the 2023 MASLD nomenclature) conducted across Mexico's 32 states and nationally. We examined key burden indicators like mortality, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALY). We used a Joinpoint regression to identify significant trends and the Pearson correlation coefficient to estimate the relationship between DALY rates and the SDI. Between 1990 and 2023, the national MASLD deaths increased significantly by 229%. Male DALY rates were 2.2 times higher than female rates in 2023, and premature mortality accounted for almost all the burden (around 97%). YLD rates increased significantly, particularly among males, indicating a growing contribution of disability to the total impact of the disease. Sub-nationally, DALY rates rose significantly in 21 states, although declines occurred in Mexico City, Hidalgo, and Jalisco. Nationally, a significant positive correlation (0.71) was found between the DALY rates and the SDI. These results suggest that socioeconomic development in most regions is associated with the adoption of unhealthy lifestyles and dietary patterns. Future policy interventions must include targeted health campaigns, especially for adult men and women aged between 60-84 years, to mitigate the accelerating trend, alongside regulatory actions necessary to control Mexico's obesogenic environment.

Objective: To evaluate the factors related to the use of the Electronic Medical Record(ECE) from the perception of medical users of health services Morelos, Mexico.Material and methods: The qualitative analysis of 22 semi-structured interviewswith medical personnel, nurses, managers and administrators of a 2nd level hospital inMorelos, Mexico was carried out, taking as a reference for analysis the dimensions ofregulations, operability and training in the implementation of the ECE.Results: An insufficient number of computers and trained personnel were identified tooperate the ECE. When it is possible to operate the file, it is slow or presents frequentsystematic failures due to the navigation networks, they depend on the central browserthat provides state support to the ECE platform without a prompt resolution whenthere are failures, the hospital units work 24 hours and centrally. ECE operations have8-hour hours from Monday to Friday. This increases resistance to adopting the file as aworking tool. The organization contributes to the resistance by not providing sufficientand permanent technical support to face the operational failures of the ECE. Usersconsider that the file is safe and reliable, which would increase the possibility of usingthe ECE.Conclusions: The lack of resources and inefficiencies in the operation of the ECEcontribute to a low and slow adoption of the file; as well as the resistance to use it.The organization helps increase resistance if training is not efficient. Lack gives youcontinuous and sufficient support in the technical infrastructure and human resources.Despite the limited and inefficient adoption of ECE, areas and personnel were identifiedwhere there is greater use (hospitalization and medical personnel). These could bepositive learning experiences that can be used to educate the entire organizationKeywords: Electronic Medical Record; Utilization

Background: Fluctuations in body mass index (BMI) have been associated with frailty, functional decline, and increased morbidity and mortality. However, evidence on the longitudinal evolution of weight status in aging populations remains limited. This study aimed to characterize population-level patterns and individual longitudinal fluctuations in BMI-defined weight status among Mexican adults aged 50 years and older between 2001 and 2021 and to examine factors associated with BMI categories across survey waves. Methods: This observational study was based on a secondary analysis of data from the Mexican Health and Aging Study (ENASEM). Data from the 2001, 2003, 2012, 2015, 2018, and 2021 survey waves were analyzed. Weight status was classified according to BMI as underweight, normal weight, overweight, or obesity. Differences in weight status were assessed using χ² tests adjusted for the complex survey design. Results: Most participants remained in the same BMI category during follow-up; however, relevant transitions between categories were observed, particularly between 2001–2003 and 2018–2021. The longitudinal analysis showed that 32% to 38% of individuals changed BMI category between periods. Obesity showed high persistence, whereas overweight showed greater variability. Wave-specific cross-sectional analyses showed that older age was consistently associated with lower BMI-category position, whereas several socioeconomic and clinical characteristics also exhibited cross-sectional associations with BMI category across survey waves. Conclusions: Although the population-level BMI distribution showed relative stability, relevant individual-level fluctuations were observed. Age and several sociodemographic characteristics were associated with differences in weight status patterns.