Laxative use in the community-dwelling elderly.
BACKGROUND: Constipation, a common and sometimes severe problem in the elderly, is often treated with laxatives. OBJECTIVE: The purpose of this study was to determine the prevalence of laxative use and identify determinants of such use among representative black and white community-dwelling elderly persons. METHODS: This was a cross-sectional survey of 4136 participants at baseline (1986-1987) in the Duke University Established Populations for Epidemiologic Studies of the Elderly. Data on demographic characteristics, health status, health service use, and use of prescription and over-the-counter drugs were collected in participants' homes. Use of the following types of laxatives was examined: bulking, hyperosmotic, lubricant, stimulant, stool softener, saline, and miscellaneous agents. RESULTS: It was found that 10.2% of participants used > or =1 laxative. Stimulants and bulking agents were the most commonly used classes. Only 11.6% of laxative users reported concurrent consumption of > or =2 laxatives. Multivariate logistic regression analyses indicated that laxative use was more likely in women (adjusted OR, 1.78; 95% CI, 1.34-2.37), those with >4 physicians visits in the previous year (adjusted OR, 1.72; 95% CI, 1.16-2.53), those unable to walk a half mile (adjusted OR, 1.44; 95% CI, 1.11-1.87), and those using > or =4 over-the-counter nonlaxative medications (adjusted OR, 2.09; 95% CI, 1.15-3.81). A nonsignificant association was seen between laxative use and the use of anticholinergic agents (adjusted OR, 1.38; 95% CI, 1.00-1.89). CONCLUSIONS: Laxative use is common among community-dwelling elderly persons and is related to specific factors concerning sociodemographics, health status, and access to health care. Studies are needed that examine the impact of laxative use on bowel function and quality of life in the elderly.
Ruby, CM; Fillenbaum, GG; Kuchibhatla, MN; Hanlon, JT
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