Higher frailty burden in older adults with chronic constipation

Jihye Lim,Eunju Lee,Il-Young Jang,Heayon Lee,Hyungchul Park,Danbi Lee,Hee-Won Jung

doi:10.1186/s12876-021-01684-x

Abstract

BackgroundDespite constipation being a common clinical condition in older adults, the clinical relevance of constipation related to frailty is less studied. Hence, we aimed to investigate the association between chronic constipation (CC) and frailty in older adults.MethodsThis is a cross-sectional analysis of a population-based, prospective cohort study of 1278 community-dwelling older adults in South Korea. We used the Rome criteria to identify patients with irritable bowel syndrome with predominant constipation (IBS-C) and functional constipation (FC). We investigated whether participants consistent with the criteria for IBS-C and FC had CC. Frailty was assessed using the Cardiovascular Health Study (CHS) frailty phenotype.ResultsIn the study population with a mean age of 75.3 ± 6.3 years, 136 (10.7%) had CC. The participants with CC were older, had higher medication burdens, and had worse physical performances compared to those without CC (All P < .05). By association analysis, the prevalence of CC was associated with frailty by the CHS criteria (P < .001). The CHS frailty score was associated with the presence of CC by the univariate logistic regression analysis and the multivariate analysis adjusted for age, sex, and multimorbidity.ConclusionsFrailty was associated with CC in community-dwelling older people, suggesting that constipation should be considered as an important geriatric syndrome in clinical practice concerning frail older adults.

Highlights

Despite constipation being a common clinical condition in older adults, the clinical relevance of con‐ stipation related to frailty is less studied
Study design and participants In this cross-sectional study, we used the records of the Aging Study of Pyeongchang Rural Area (ASPRA), an ongoing population-based, prospective cohort study of older adults in Pyeongchang, Gangwon, South Korea, established in 2014
The difference between the severity scores was not significant between the prefrail and frail groups (P = .322). In this cross-sectional study, we found that the prevalence of chronic constipa‐ tion (CC) was associated with the frailty phenotype; this association was maintained after adjusting for possible confounders

Summary

Introduction

Despite constipation being a common clinical condition in older adults, the clinical relevance of con‐ stipation related to frailty is less studied. The incidence of constipation is influenced by age, diet, lifestyle, and medical conditions, while medications are a known major cause of constipation in older adults [5, 6]. A common clinical syndrome in older adults, is defined as a decrease in the physiological reserve with aging and an increased vulnerability to stressors [10]. Since frailty often co-exists with multimorbidity and decreased daily function, the interaction between the frailty spectrum and the underlying disease is an important issue in the clinical decision making process for older adults [14].

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