Factor analysis of defecation status in the general elderly population: the Yamagata Cohort Study

The prevalence of constipation is increasing with the aging of the population, significantly impacting the quality of life in older adults. However, a comprehensive analysis of the physical, psychological, and social correlates of constipation in Japan remains limited. This study aimed to examine factors associated with defecation status in community-dwelling older adults in Japan.

We conducted a cross-sectional analysis of 8,009 community-dwelling residents aged 65 years and older who completed the baseline health and lifestyle questionnaire as part of the Yamagata Cohort Study. Constipation was defined as fewer than three bowel movements per week. Physical, psychological, and social factors were assessed using self-administered questionnaires. Associations with constipation were examined using chi-square tests and multivariable logistic regression, including sex-stratified models.

Constipation was observed in 407 participants (5.1%). In the multivariable analysis, it was significantly associated with being female (odds ratio [OR] = 1.26, 95% confidence interval [CI]: 1.02-1.56; reference: male), having a body mass index (BMI) ≥25 kg/m² (OR = 0.74, 95% CI: 0.58-0.96: reference: <25 kg/m²), feeling unhappy (OR = 1.94, 95% CI: 1.16-3.22; reference: happy), experiencing residual stool sensation (OR = 2.77, 95% CI: 2.11-3.64; reference: no sensation), having moderate overactive bladder (OAB) symptoms (OR = 1.42, 95% CI: 1.13-1.79; reference: no OAB symptoms), and perceived living situation on current income as difficult (OR = 1.70, 95% CI: 1.36-2.12; reference: comfortable). Sex-stratified analyses revealed partially different patterns of associated factors between men and women.

Constipation in community-dwelling older adults in Japan was associated with multiple physical, psychological, and social factors, with sex-specific differences. Given the cross-sectional design, causality cannot be inferred. These findings suggest that constipation in older adults may be associated with a complex interplay of physical, psychological, and social factors, highlighting the need for comprehensive and integrated approaches in community settings. Integrated geriatric care that addresses these dimensions may be effective in preventing and managing constipation in this population.