The Association between Sarcopenia and Constipation Onset in Community-dwelling Older Adults in Japan

Objective Constipation is an important symptom in older adults. Sarcopenia is associated with constipation, but its directionality remains unclear. The present study assessed the association between sarcopenia and new-onset constipation. Methods This prospective cohort study assessed sarcopenia at baseline in 2019 using the the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls (SARC-F) questionnaire. Sarcopenia was defined as a SARC-F score of ≥4. Constipation was measured in 2019 and 2020 based on self-reported constipation or laxative use, using a self-administered questionnaire. Logistic regression was used to estimate the association between new-onset constipation in 2020 and sarcopenia status at the baseline. Patients Independent community-dwelling adults ≥75 years old in Sukagawa City, Fukushima, Japan. Results The analysis included 2,388 participants without constipation at baseline (mean age: 80.0±4.3 years old; 44.9% men), of whom 310 (13.0%) had sarcopenia at baseline. Overall, 262 participants (11.0%) developed constipation, including 57 of 310 (18.4%) with sarcopenia and 205 of 2,078 (9.9%) without sarcopenia. Participants with sarcopenia had a significantly higher risk of developing constipation than those without sarcopenia after adjusting for age, sex, lifestyle factors, and comorbidities (adjusted odds ratio, 1.98; 95% confidence interval, 1.40-2.81; p<0.001). The association between sarcopenia and new-onset constipation remained statistically significant at higher and lower SARC-F cutoff values. Conclusion Sarcopenia was associated with new-onset constipation. Sarcopenia is a risk factor for constipation in independent community-dwelling older adults ≥75 years old. Measures addressing sarcopenia may help prevent constipation in older adults.