Constipation and Malnutrition in the Elderly Living in Long-Term Care Facilities: A Cross-Sectional Study

Hannah Vogel, RD; Sophia Jhajj, RD; Biljana Jonoska Stojkova, Ph.D.; Peter Zakrzewski, MD, FRCSC; Claudia Lemay, RD

*Correspondence Email Address: [email protected]


Background: Constipation and malnutrition are common health concerns for elderly populations in long-term care facilities. Our hypothesis is that weight loss, and consequently, malnutrition will be higher in constipated residents. Objectives: To determine whether constipation in residents in long-term care (LTC) facilities leads to weight loss and subsequently malnutrition, poor quality of life, and mortality, to guide best practices for bowel protocols. Methods: A total of 474 eligible participants living in 15 LTC facilities were recruited for the study. Residents were observed for over three months, and categorized by the number of bowel interventions (laxatives and suppositories) received as a proxy for constipation. Bodyweight (BW) and calf circumference (CC) were measured at baseline and the end of each month and compared to determine if constipation was associated with an increased rate of weight loss and CC loss. Results: Residents in the moderate-to-severe constipation group had 1.315 (CI 95%; 0.618, 2.797) times higher or 31.5% increased odds of having weight loss ≥7.5% over three months than residents in the no-to-mild constipation group. The observed effect for BW was not statistically significant. Conclusion: Our study provides support that constipation can lead to weight loss, highlights the need for appropriate bowel protocols in LTC facilities and relates to the importance of having Registered Dietitians on staff in LTC facilities to advocate for residents with constipation.

Keywords: Bowel Management, Calf Circumference, Constipation, Malnutrition, Long-term
Care, Weight Loss

Citation: Vogel H, Jhajj S, Stojkova BJ, Zakrzewski P, Lemay C. Constipation and Malnutrition
in the Elderly Living in Long-Term Care Facilities: A Cross-Sectional Study. Canadian Journal
of Clinical Nutrition. 2023; 11 (1): 6-27.