Association between frailty and chronic constipation and chronic diarrhea among American older adults: National Health and Nutrition Examination Survey
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ABSTRACT:
SUBMITTER: Liu X
PROVIDER: S-EPMC10647084 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
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Project description:BackgroundRenal stone is a highly prevalent life-long disease with a high recurrence rate. Chronic bowel diseases, including chronic gastrointestinal symptoms (chronic constipation or chronic diarrhea), are common gastrointestinal problems. We aimed to evaluate the associations of chronic constipation and chronic diarrhea with renal stones.MethodsThis large-scale, cross-sectional study was performed within participants (≥20 years old) from the National Health and Nutrition Examination Survey from 2007 to 2010. Logistic regression and sensitivity analyses were conducted to clarify the association between chronic bowel diseases and renal stones.ResultsA total of 8,067 participants aged ≥20 years were included. The prevalence of renal stones is 9.14%. Chronic diarrhea was positively related to the risk of renal stones [odds ratio (OR) =1.681, 95% confidence interval (CI): 1.212 to 2.330, P=0.004] after adjusting for all covariates. In participants with body mass index (BMI) over 30 kg/m2, chronic constipation was correlated with kidney stones in fully adjusted model 2 (OR =2.142, 95% CI: 1.389 to 3.303, P=0.004).ConclusionsOur findings provide evidence that chronic diarrhea is associated with an increased risk of renal stones. Chronic constipation is positively related to the risk of renal stones in participants with BMI over 30 kg/m2. Health care should focus more on bowel health status for the prevention of related diseases. More prospective cohort studies are needed.
| S-EPMC11491232 | biostudies-literature
Project description:BackgroundStudies have shown that there is a relationship between smoke exposure and constipation. However, there are limited data on the associations between constipation and smoking or serum cotinine levels, a metabolite of nicotine commonly used as a marker of tobacco exposure.MethodsThis study thoroughly examined the cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2010. We applied multivariate logistic regression models to assess the association between tobacco smoking status, serum cotinine levels, and constipation.ResultsIn this cross-sectional study, 11,651 participants were included. The average age of the participants was 48.8 ± 17.9 years. After controlling for covariates, there was no significant relationship between serum cotinine levels, smoking status, and constipation risk. According to the categorical analysis, the incidence of constipation was 36% higher in participants with serum cotinine levels between 0.05 and 2.99 ng/mL (model 1: OR = 1.45 [1.13-1.85]; model 2: OR = 1.44 [1.12-1.83]; and model 3: OR = 1.36 [1.06-1.74]; p < 0.05) after adjusting for covariates by using the lowest levels of serum cotinine (<0.05 ng/mL) as a reference. In the non-smokers, serum cotinine levels were linearly and positively associated with the risk of constipation (p > 0.05), and the relationship between smoke exposure and constipation remained relatively stable in across all subgroups.ConclusionThe study suggests that serum cotinine levels have a promoting effect on stool frequency-related constipation in non-smokers. Therefore, avoiding passive smoking as much as possible may reduce the effect of smoke exposure on constipation and serve as a preventive measure for treatment.
| S-EPMC11920834 | biostudies-literature
Project description:AimThe study aimed to explore potential links between long-term digestive issues (specifically diarrhea and constipation) and body roundness index (BRI) in a representative U.S. population sample.MethodsThis study adopted a design that is cross sectional, drawing on data from the NHANES, gathered from 2005 to 2010 with health information from a total of 11,235 individuals. Persistent bowel movement patterns were categorized based on the BSFS-Bristol Stool Form Scale, while stool types 1 and 2 were designated as indicators of long-term constipation and types 6 and 7 were identified as markers of persistent diarrhea. To assess the relationship between digestive health and the BRI, this study employed weighted logistic regression analysis. To capture and visualize the nuanced interplay between BRI and gastrointestinal patterns, we utilized advanced nonlinear regression methods, specifically restricted cubic spline (RCS) analyses. Additionally, the research compared the efficacy of various physical measurements-including BRI, WC, BMI (body roundness index, waist circumference, and body mass index, respectively)-to determine their respective diagnostic power for chronic diarrhea and constipation through comparative analysis of receiver operating characteristic (ROC) curves.ResultsAfter comprehensive adjustment in the final statistical model (Model 3), the BRI demonstrated the statistically significant associations with diarrhea and persistent constipation. RCS analysis further uncovered statistically significant nonlinear positive associations of BRI and with diarrhea (P = 0.005) and constipation (P = 0.037). Further stratified analyses revealed that the relationship between BRI and persistent diarrhea was particularly evident among individuals with diabetes. In contrast, the association between BRI and constipation was stronger in individuals under 60 years of age. ROC analysis indicated that BRI outperformed conventional anthropometric measures (AUC, area under the curve: 0.601). Specifically, BMI resulted in an AUC of 0.569, while WC produced an AUC of 0.572. However, the AUC value of BRI (0.537) was less effective than BMI (0.551) and WC (0.570) in diagnosing constipation.ConclusionsBRI is strongly associated with changes in the individual's bowel habits, particularly in diagnosing chronic diarrhea. This study highlighted the potential significance of maintaining moderate BRI levels to improve bowel health and prevent diarrhea.
| S-EPMC11783814 | biostudies-literature
Project description:BackgroundSeveral studies suggest a link between micronutrients and constipation. However, the relationship between constipation and phosphorus has rarely been examined. The main aim of this study was to investigate the association between changes in the prevalence of chronic constipation and dietary phosphorus intake among adult respondents of the National Health and Nutritional Examination Survey (NHANES).MethodsData were extracted from the NHANES database for the years 2005-2010. A total of 13,948 people were included in the analysis. Dietary information was collected using the respondents' 24-h dietary records. We conducted multiple logistic regression analyses to examine the correlation between phosphorus intake and poor bowel movement. The primary and secondary outcomes was constipation defined by stool consistency and stool frequency, respectively.ResultsFollowing multi-variate adjustment in model III, a significant association between chronic constipation and each additional 0.1-g intake of dietary phosphorus (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.95, 1.00; P = 0.034 for stool consistency vs. OR, 0.94; 95% CI, 0.90, 0.99; P = 0.027 for stool frequency) was observed. Following multi-variate adjustment in model III, OR values and 95% CI from the second to fourth quartiles compared to the first quartile (reference group) were 0.92 (0.66, 1.27), 0.73 (0.47, 1.13), and 0.39 (0.20, 0.76), respectively, using the stool frequency definition.ConclusionsThis study revealed a negative correlation between phosphorus intake and chronic constipation. This may be due to the fact that dietary phosphorus intake is associated with softer stools and increased stool frequency. Further studies in different settings should be considered to verify these findings.
| S-EPMC9875444 | biostudies-literature
Project description: Not available
| S-EPMC10916608 | biostudies-literature
Project description:BackgroundThe impact of per- and polyfluoroalkyl substances (PFAS) on constipation, as mediated through gastrointestinal absorption and perturbations to the intestinal microecology, remains poorly understood.ObjectiveThis study seeks to explain the relationship between PFAS and constipation.MethodsA total of 2945 adults from the National Health and Nutrition Examination Survey (NHANES) 2005-2010 were included in this study. Constipation was defined using the Bristol Stool Form Scale (BSFS) based on stool consistency. The relationship between PFAS and constipation was evaluated using weighted logistic regression and restricted cubic spline (RCS) analysis, while adjusting for confounding variables.ResultsThe weighted median concentration of total PFAS (ΣPFAS) was significantly lower in individuals with constipation (19.01 μg/L) compared to those without constipation (23.30 μg/L) (p < 0.0001). Subgroup analysis revealed that the cumulative effect of PFAS was more pronounced in the elderly, men, individuals with obesity, high school education or equivalent, and high-income individuals (p < 0.05). After adjusting for confounding factors, multivariable analysis demonstrated an inverse association between PFOA [OR (95% CI), 0.666(0.486,0.914)] and PFHxS [OR (95% CI), 0.699(0.482,1.015)], and constipation. None of the personal and lifestyle factors showed a significant correlation with this negative association, as confirmed by subgroup analysis and interaction testing (p for interaction > 0.05). The RCS analysis demonstrated a linear inverse relationship between PFAS levels and constipation.ConclusionThe findings of this study provide evidence of a significant inverse correlation between serum concentrations of PFAS, particularly PFOA and PFHxS, and constipation.
| S-EPMC10984548 | biostudies-literature
Project description:BackgroundDespite constipation being a common clinical condition in older adults, the clinical relevance of constipation related to frailty is less studied. Hence, we aimed to investigate the association between chronic constipation (CC) and frailty in older adults.MethodsThis is a cross-sectional analysis of a population-based, prospective cohort study of 1278 community-dwelling older adults in South Korea. We used the Rome criteria to identify patients with irritable bowel syndrome with predominant constipation (IBS-C) and functional constipation (FC). We investigated whether participants consistent with the criteria for IBS-C and FC had CC. Frailty was assessed using the Cardiovascular Health Study (CHS) frailty phenotype.ResultsIn the study population with a mean age of 75.3 ± 6.3 years, 136 (10.7%) had CC. The participants with CC were older, had higher medication burdens, and had worse physical performances compared to those without CC (All P < .05). By association analysis, the prevalence of CC was associated with frailty by the CHS criteria (P < .001). The CHS frailty score was associated with the presence of CC by the univariate logistic regression analysis and the multivariate analysis adjusted for age, sex, and multimorbidity.ConclusionsFrailty was associated with CC in community-dwelling older people, suggesting that constipation should be considered as an important geriatric syndrome in clinical practice concerning frail older adults.
| S-EPMC7995705 | biostudies-literature
Project description:BackgroundPrevious research has suggested that poor oral health is positively associated with frailty. The objective of this study was to explore associations of key oral diseases (periodontal disease, tooth loss), and oral hygiene and management behaviors with the level of frailty in community-dwelling older Korean adults using national representative survey data.MethodsThis study used cross-sectional, 6th and 7th Korea National Health and Nutrition Examination Survey (KNHANES VI, VII) data. Adults aged 50+ years were included. Frailty was measured using frailty phenotype (FP) and frailty index (FI). FP was determined using five frailty criteria, i.e., weight loss, weakness, exhaustion, slowness, or low physical activity, and the level of frailty was classified with the number of criteria present (robust, none; pre-frail, 1-2; frail, 3+). FI was determined using a 44-item FI constructed according to a standard protocol, and the level of frailty was classified as robust (FI: ≤ 0.08), pre-frail (FI: 0.08-0.25), and frail (FI: ≥ 0.25). Multiple ordinal regression analyses were conducted with each type of frailty as the outcome variable. Independent variables of interest were the periodontal status, number of teeth, and practices on oral hygiene and management. Analyses were additionally adjusted for participants' socioeconomic, diet, and behavioral characteristics.ResultsThe prevalence of frailty was 4.38% according to the FP classification (n = 4156), 10.74% according to the FI classification (n = 15,073). In the final adjusted model, having more teeth and brushing after all three meals were significantly associated with lower odds of being more frail (in both frailty models); no significant association was observed between periodontal disease and frailty.ConclusionsFindings from this study show having more teeth and practicing adequate brushing are significantly associated with frailty. Due to limitations of the study design, well-designed longitudinal studies are needed to confirm these findings.
| S-EPMC9044774 | biostudies-literature
Project description:Reducing population-level sodium intake can reduce hypertension, an important preventative strategy to lower the risk of cardiovascular diseases, the leading cause of death in the United States. Considering that most dietary sodium is derived from prepackaged foods, this study quantitatively estimates the proportion contribution and mean sodium intake from key food category contributors to total sodium intake in the US population. Data from the 2017-2018 National Health and Nutrition Examination Survey, which collected interviewer-administered 24 h dietary recalls from Americans (n = 7081), were analyzed. Based on the average proportion contributed, the top 15 sources of sodium were identified overall and by age/sex, poverty-income and race/ethnicity. More than 50% of US population-level dietary sodium intake was contributed by: pizza (5.3%); breads, rolls and buns (4.7%); cold cuts and cured meats (4.6%); soups (4.4%); burritos and tacos (4.3%); savoury snacks (4.1%); poultry (4.0%); cheese (3.1%); pasta mixed dishes (2.9%); burgers (2.5%); meat mixed dishes (2.5%); cookies, brownies and cakes (2.4%); bacon, frankfurters and sausages (2.4%); vegetables (2.2%); and chicken nuggets (1.5%), with the results remaining consistent among population subgroups. The results identified the top sources of sodium in the American population overall, as well as in key population subgroups, which can inform policies and programs aimed at reducing sodium intake.
| S-EPMC9962803 | biostudies-literature
Project description:BackgroundThere is only limited evidence for an association between calcium (Ca) and depression, and the relationship was inconsistent. Therefore, the aim of this study was to assess the relationship between dietary Ca and the risk of depressive symptoms in individuals over the age of 18 in the US.MethodsWe extracted 14,971 participants from the US National Health and Nutrition Examination Survey (NHANES) 2007-2016 to probe their associations. Dietary Ca intake was measured through 24 h dietary recall method. Patients with the Patient Health Questionnaire-9 (PHQ-9) ≥ 10 scores were believed to have depressive symptoms. The association between dietary Ca and depressive symptoms was investigated using multivariate logistic regression, sensitivity analysis, and restricted cubic spline regression.ResultsIn this study, 7.6% (1,144/14,971) of them had depressive symptoms. After adjusting for sex, age, race, poverty to income ratio (PIR), marital status, education, body mass index (BMI), caffeine intake, carbohydrates intake, total energy intake, smoking status, alcohol consumption, physical activity, diabetes, hypertension, severe cardiovascular disease (CVD), cancer, serum vitamin D, serum Ca, and Ca supplement, the adjusted ORs value [95% confidence interval (CI)] of depression for the lowest category (Q1 ≤ 534 mg/day) vs. Q2-Q4 of Ca intake were 0.83 (0.69-0.99), 0.97 (0.65-0.95), and 0.80 (0.63-0.98) with the p for trend (p = 0.014). The relationship between dietary Ca intake and depressive symptoms was linear (non-linear p = 0.148). None of the interactions were significant except among races (p for interaction = 0.001).ConclusionAssociation between dietary Ca and the prevalence of depressive symptoms in US adults. And Ca intake was negatively associated with the risk of depressive symptoms. As Ca intake increased, the prevalence of depressive symptoms decreased.
| S-EPMC9948022 | biostudies-literature