Development of constipation in nursing home residents

PURPOSE: Constipation is a common complaint among geriatric patients and ma y result in significant morbidity, especially among nursing home residents. The prevalence of constipation increases with advancing age and may be a r esult 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 develop ment of constipation in a large population of nurs ing home residents. METHODS: The Minimum Data Set is an assessment instrume nt used in nearly all Medicare-certified and Medicaid-certified nursing fac ilities, Nursing home residents who were at least 65 years of age and who h ad assessments at baseline and at three months were included in the study ( N = 21,012). Baseline risk; factors were included in a multivariate logisti c regression to determine their association with the development of constip ation. To allow causal implications, nursing home residents with constipati on at baseline were excluded. The variables examined included medications, mobility, comorbid illness, and nutrition. RESULTS: The mean age (+/- stand ard deviation),of nursing home residents was 83 +/- 8 years, and the popula tion was 70 percent female and 83 percent white. At baseline, the prevalenc e of constipation was 12.5 percent (N = 2,627). By the three-month assessme nt, 7 percent (N = 1,291) of nursing home residents had developed constipat ion. The factors associated independently with the development of constipat ion were in order of magnitude, race, decreased fluid intake, pneumonia, Pa rkinson's disease, and the presence of allergies. Congestive heart failure and the use of a feeding tube were two factors identified as having a prote ctive effect. CONCLUSION: The variables associated with the development of constipation may be used to identify geriatric nursing home residents at ri sk and to prevent constipation and its potential complications. Further stu dy is needed to demonstrate a causal relationship between the risk factors and the development of constipation.