Abstract
PURPOSE: Constipation is a common complaint among geriatric patients and may result in significant morbidity, especially among nursing home residents. The prevalence of constipation increases with advancing age and may be a result of the aging process, but the exact cause is unknown. The aim of this study was to describe the prevalence of constipation and to determine risk factors for the development of constipation in a large population of nursing home residents. METHODS: The Minimum Data Set is an assessment instrument used in nearly all Medicare-certified and Medicaid-certified nursing facilities. Nursing home residents who were at least 65 years of age and who had assessments at baseline and at three months were included in the study (N = 21,012). Baseline risk factors were included in a multivariate logistic regression to determine their association with the development of constipation. To allow causal implications, nursing home residents with constipation at baseline were excluded. The variables examined included medications, mobility, comorbid illness, and nutrition. RESULTS: The mean age (± standard deviation) of nursing home residents was 83±8 years, and the population was 70 percent female and 83 percent white. At baseline, the prevalence of constipation was 12.5 percent (N=2,627). By the three-month assessment, 7 percent (N=1,291) of nursing home residents had developed constipation. The factors associated independently with the development of constipation were, in order of magnitude, race, decreased fluid intake, pneumonia, Parkinson's disease, and the presence of allergies. Congestive heart failure and the use of a feeding tube were two factors identified as having a protective effect. CONCLUSION: The variables associated with the development of constipation may be used to identify geriatric nursing home residents at risk and to prevent constipation and its potential complications. Further study is needed to demonstrate a causal relationship between the risk factors and the development of constipation.
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References
Sonnenberg A, Koch TR. Epidemiology of constipation in the United States. Dis Colon Rectum 1989;32:1–8.
Tedesco FJ, DiPiro JT. American College of Gastroenterology's Committee on FDA-related matters. Am J Gastroenterol 1985;30:303–9.
Sonnenberg A, Koch TR. Physician visits in the United States for constipation: 1958 to 1986. Dig Dis Sci 1989;34:606–11.
Read NW, Abouzekry L, Read MG, Howell P, Ottewell D, Connelly TC. Anorectal function in elderly patients with fecal impaction. Gastroenterology 1985;89:959–66.
Wrenn K. Fecal Impaction. N Engl J Med 1989;321:658–62.
Harari D, Gurwitz JH, Avorn J, Choodnovskiy I, Minaker KL. Correlates of regular laxative use by frail elderly persons. Am J Med 1995;99:513–8.
Korzets A, Dicker D, Chaimoff C, Zevin D. Life-threatening hyperphosphatemia and hypocalcemic tetany following the use of Fleet enemas. J Am Geriatr Soc 1992;40:620–1.
Pahor M, Guralnik JM, Chrischilles EA, Wallace RB. Use of laxative medication in older persons and associations with low serum albumin. J Am Geriatr Soc 1994;42:50–6.
Morris JN, Hawes C, Fries BE,et al. Designing the National Assessment Instrument for nursing homes. Gerontologist 1990;30:293–307.
Kiely DK, Kiel DP, Burrows AB, Lipsitz LA. Identifying nursing home residents at risk for falling. J Am Geriatr Soc 1998;46:551–5.
Hawes C, Morris JN, Phillips CD,et al. Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). Gerontologist 1995;35:172–8.
Sgadari A, DuPaquier J, Fries BE,et al. Efforts to establish the reliability of the MDS/RAI. Age Aging 1997;26:27–30.
Allen, JE. Long term care facility resident assessment instrument user's manual: for use with version 2.0 of HCFA minimum data set resident assessment protocols and utilization guidelines, October 1995. New York: Springer, 1997.
Everhardt JE, Go VL, Johannes RS,et al. A longitudinal survey of self-reported bowel habits in the United States. Dig Dis Sci 1989;34:1153–62.
Harari D, Gurwitz JH, Minaker KL. Constipation in the elderly. J Am Geriatr Soc 1993;41:1130–40.
Klauser AG, Schindlbeck NE, Muller-Lissner SA. Low fluid intake lowers stool output in healthy male volunteers. Z Gastroenterol 1990;28:606–9.
Whitehead WE, Drinkwater D, Cheskin LJ, Heller BR, Shuster MM. Constipation in the elderly living at home: definition, prevalence, and relationship to lifestyle and health status. J Am Geriatr Soc 1989;37:423–9.
Romero Y, Evans JM, Fleming KC, Phillips SF. Constipation and fecal incontinence in the elderly population. Mayo Clin Proc 1996;71:81–92.
Hollingworth J, Alexander-Williams J. Non-steroidal anti-inflammatory drugs and stercoral perforation of the colon. Ann R Coll Surg Engl 1991;73:337–9.
Edwards IR, Coulter DM, Macintosh D. Intestinal effects of captopril. BMJ 1992;304:359–60.
Klauser AG, Voderholzer WA, Heinrich CA, Schindlebeck NE, Muller-Lissner SA. Behavioral modification of colonic function: can constipation be learned? Dig Dis Sci 1990;35:1271–5.
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Robson, K.M., Kiely, D.K. & Lembo, T. Development of constipation in nursing home residents. Dis Colon Rectum 43, 940–943 (2000). https://doi.org/10.1007/BF02237354
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DOI: https://doi.org/10.1007/BF02237354