Functional Constipation is Associated with a Decline in Word Recognition 2 Years Later in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study

BACKGROUND: Consumption and cognitive impairment are the most common health problems among older adults. This study aimed to determine the effects of functional constipation on cognitive decline in community-dwelling older adults. METHODS: This was a 2-year longitudinal analysis of Korean Frailty and Aging Cohort Study data, including 851 community-dwelling residents who participated in both the baseline and follow-up surveys. A neuropsychological test, the Consortium to Establish a Registry for Alzheimer's Disease Assessment Battery (CERAD-K), and the Korean version of the Frontal Assessment Battery (FAB) were used to evaluate cognitive function. Functional constipation was defined according to the ROME IV criteria. An analysis of covariance was used to identify the association between functional constipation and cognitive decline. RESULTS: Among the 851 participants, 8.9% had functional constipation. The patients in the constipation group were more likely to have low physical activity (15.8% vs. 8.8%), polypharmacy (61.8% vs. 45.5%), and depression (30.3% vs. 17.4%) than the non-constipation group. After adjusting for potential confounding factors, including age, sex, education years, low physical activity, polypharmacy, type 2 diabetes mellitus, depression, and baseline Cognitive Function Test score, the mean changes in Word Recognition test scores from 2018 to 2020 were -0.07 and -0.54 in the non-constipation and constipation groups, respectively (p=0.007). Other cognitive function tests (Mini-Mental State Examination, word list memory, word list recall, digit span, trail-making test, and FAB) did not show any difference in decline between the two groups (p>0.05). CONCLUSIONS: Functional constipation at baseline was associated with a decline in word recognition after 2 years.