Oct 20, 2020

76% of aged care residents suffer constipation, study finds


Constipation is the most common ailment among aged care residents, and it could be in part because providers are spending less on fresh food, researchers say.

Researchers Dr Kimberly Lind and Dr Magda Raban, from Macquarie’s Australian Institute of Health Innovation, said the finding that constipation had the highest prevalence of all conditions studied was “unexpected”.

“Although constipation can be an acute condition, it can also occur chronically, and we found that it was indeed a recurring problem for residents,” they wrote in their findings. 

Water, activity, fibre

The researchers were able to identify the extent that residents suffered constipation through data on the use of laxatives. They also noted that constipation can be a side effect of medication and certain health conditions.

Fortunately, constipation can be improved with “optimal adequate hydration, physical activity, and fibre intake”, they recommended. 

Decreased spending on fresh food a likely cause 

The increased use of food supplements and “decreasing spending” on fresh food in aged care homes may be “exacerbating the problem of chronic constipation”, they noted. 

“These data highlight the need for attention to this overlooked issue that can have a substantial impact on the quality of life of residents.

“The focus needs to shift from treatment of constipation to prevention,” they wrote. 

The study

Older people in residential aged care often have multiple health conditions, but there is minimal information about the prevalence of health conditions among this population, the researchers said.

Very old Australians and aged care residents are under-represented in national health surveys, meaning critical information about the number of Australians affected by common geriatric diseases, such as dementia, the second leading cause of death in Australia, is limited.

The study used data from aged care funding assessments (ACFI), medication administration records, and clinical notes from facility electronic health records to find the most common ailments among residents.

They used data from 9,436 residents of 68 large, not-for-profit aged care providers in NSW and the ACT. 

(While aged care homes’ electronic health records were a rich source of clinical information about residents, the researchers observed many of the systems are not set up to create reports, and as such, the data remains “underutilised”.)

The researchers generated ‘prevalence estimates’ across age brackets and gender for 60 health conditions. 

58% living with dementia

The study showed that 93% of residents had a circulatory disease, with hypertension the most common (62%). Most residents (93%) had a mental or behavioural disorder, such as dementia (58%) or depression (54%). 

Among the specific conditions, constipation had the largest number of cases and greatest prevalence, at 133,302 cases, or 76%.

This was followed by: 

  • hypertension (110,508, 62%)
  • arthritis (106,116, 61%)
  • dementia (104,698, 58%)
  • peptic ulcer disease/gastro-oesophageal reflux disease (104,279, 58%)
  • depression (100,791, 54%)
  • urinary incontinence (89,725, 51%)
  • dyslipidemia (85,320, 44%)
  • pain (69,687, 39%), and 
  • chronic lower respiratory disease (64,113, 35%). 

Reports underestimate health problems in aged care

The prevalence of many health conditions among aged care residents in Australia is “underestimated” in previous reports, the researchers said.

For most health conditions, electronic health records identified approximately twice the number of people with the condition compared to ACFI assessments. 

“Many of the… conditions that were revealed as highly prevalent, such as depression, arthritis, dementia, and chronic lower respiratory disease, could be improved through a holistic approach to management that includes improvements in lifestyle behaviours, diet, physical activity, and social participation in meaningful activities, which are currently not funded in Australia,” the researchers noted.


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