Constipation in the elderly from Northern Sardinia is positively associated with depression, malnutrition and female gender

Abstract

Objectives: Constipation is a common complaint in older adults. The rise in life expectancy may amplify the problem and increase social expenditure. We investigated the major risk factors associated with constipation in a large sample of elderly.

Methods: Outpatients from Northern Sardinia attending a Geriatric Unit between 2001 and 2014 were enrolled. Demographic and anthropometric data, income, education and self-reported bowel function were collected. The presence of constipation was adjusted for cognitive status, assessed by the Mini-Mental State Examination (MMSE) test; single and cumulative illness rating scale (CIRS); current or past symptomatic depression and anxiety measured by the Geriatric Depression Scale (GDS); nutritional status, evaluated using the Mini-Nutritional Assessment (MNA); type and number of different medications used.

Results: 1328 elderly patients (mean age 77.7 ± 7.2 years) were enrolled. Constipation was present in 32.1%, more commonly in women (35.4% vs 28.3%) and increased with age. The multivariate analysis showed a significantly greater risk of constipation in patients with a risk of malnutrition (OR = 1.745, 95% CI: 1.043–2.022; p = .034), female gender (OR = 1.735, 95% CI: 1.068–2.820; p = .026) and depression (OR = 1.079, 95% CI: 1.022–1.140; p = .006). Other potential predisposing factors assessed such as MMSE, CIRS, body mass index, marital status, smoking habit, education, income and number of taken drugs did not show a statistically significant association. Aging was a risk for constipation also in patients free of medications.

Conclusions: Knowledge of risk factors associated with bowel alterations in elderly individuals may provide important clues for caregivers to prevent or reduce constipation.

Keywords:

• Bowel function
• constipation
• elderly
• mental status
• nutrition
• polypharmacy

Acknowledgements

This paper is dedicated to the memory of our dearest colleague and friend, Professor Rinaldo Tedde, geriatrician of great experience and humanity, whose efforts contributed greatly to the study.

Disclosure statement

No potential conflict of interest was reported by the authors.