Constipation and Its Associated Factors among Patients with Dementia

Abstract

Constipation is one of the most frequent non-motor problems in older adults. As constipation is commonly ignored by dementia patients, it is not usually reported on time. Constipation has a serious impact on the activity of daily living and quality of life in dementia patients. The relationships between constipation, demographic variables, and the nutritional status of patients with dementia remain unknown. This study aimed to assess the possible factors associated with constipation. This cross-sectional study was conducted at the Kaohsiung Chang Gung Memorial Hospital from January to November 2019. This hospital is a medical center and the main referral hospital of southern Taiwan, serving 3 million inhabitants. In total, 119 patients with dementia were evaluated using the Rome III diagnostic criteria for functional constipation. There were 30 patients with dementia included in the constipation group and 89 patients with dementia included in the no constipation group. Mini-Nutritional Assessment and 3-day diet diary records were employed. The clinical dementia rating score was used to evaluate the severity of dementia in patients of the outpatient clinic. Approximately 25.2% of dementia patients had constipation. Patients in the dementia with constipation group were older, had severer dementia, and displayed a lower water intake. After multivariable adjustment, low liquid consumption was the predictor of constipation among patients with dementia. The findings support the clinical recommendations to treat constipation with an increased liquid intake, but not exercise, in dementia patients.

Prevalence of Constipation in Elderly and Its Association With Dementia and Mild Cognitive Impairment: A Cross-Sectional Study

“…The specific pathogeneses of constipation and dementia are still unclear, but an increasing number of studies has shown that there is an important connection between them ( Idiaquez and Roman, 2011 ; Chen et al, 2020 ; Leta et al, 2021 ). The gut is connected to the brain through the gut-brain axis ( Rhee et al, 2009 ); that is, the central nervous system communicates with the enteric nervous system, intestinal mucosa and muscle layer through two-sided (afferent and efferent) pathways.…”

Impact of constipation on progression of Alzheimer's disease: A retrospective study

“…We therefore need to confirm our findings in a larger study. However, previous studies have reported that the prevalence rate of constipation was 15%–20% in a population over 60 years old and 25% in patients over 70 years old 13 . In this study, the prevalence rate of constipation was 23.8%, which suggests that our cases could partially represent patients of interest.…”

“…Constipation is frequently observed even in healthy adults, and its prevalence rate increases in the elderly 1,2 . Moreover, constipation can be a risk of neurodegenerative diseases, such as Parkinson's disease (PD) and Dementia with Lewy body (DLB), 23,24 while association of constipation with AD pathology is controversial 13 . Recently, the association between constipation and the gut microbiome has been extensively studied.…”

“…Homocysteine is mainly produced from intestinal mucosal cells and can induce oxidative stress, causing the damage of vessel endothelium 11 . On the contrary, several studies mentioned that mechanical or physiological factors are main cause of constipation 12–14 . The severity of AD was reported to relate to constipation because of the decrease in water intake and mobility in AD patients 13 .…”

Diagnosis and Treatment of Elderly and Senile Chronic Constipation: an Expert Consensus

“…Тяжесть запора положительно коррелирует с наличием и выраженностью когнитивных расстройств [44]. Пациенты с деменцией часто не предъявляют жалобы на наличие симптомов запора и вместо этого могут демонстрировать агрессивное поведение, что приводит к назначению антипсихотических препаратов и, как следствие, усугублению симптомов запора [45,46].…”