Factors associated with constipation in a community based sample of people aged 70 years and over

STUDY OBJECTIVE--The aim was to determine the prevalence and factors associated with constipation in elderly people. DESIGN--The study was a survey involving administration of a structured questionnaire, an interview, and a dietary assessment. SETTING--The survey was community based and the population studied was drawn from the practice records of all five general practitioners serving a rural township of 13,500 people. PARTICIPANTS--778 (91.8%) of the 856 people aged 70 years and over registered with the five practitioners took part. MAIN RESULTS--174 subjects had symptoms of infrequent bowel motions or frequent straining at stool or used laxatives regularly. Of this group, 34 had a bowel motion only every 3 d or less frequently and were considered to have constipation. Analysis of this subgroup showed that constipation was more common in women than men, increased with age, and was associated with the use of constipating drugs. Those whose bowels moved infrequently were a more frail group who were less physically active. Low intakes of dietary fibre, fruit, vegetables, bread and cereals, or fluid were not associated with an increased occurrence of constipation. There were 151 subjects who felt they were moderately constipated, but who had a bowel motion at least every 2 d. These people were more likely than the rest of the sample to use laxatives (55.6%), were more likely to take food for their bowels, to take hynoptics, and to regard their health as poor. CONCLUSIONS--About one third of people aged 70 years and over have some bowel problem such as infrequency, straining at stool, or frequent laxative use. Most modify their diet accordingly but laxative use remains high.