title: Laxative use and its relationship with straining in a London elderly population: free-living versus institutionalised.
abstract: BACKGROUND
  The diagnosis of functional constipation according to Rome II criteria includes assessment of straining. However the prevalence in older adults is unknown. Moreover, laxative use increases with age, especially in the elderly.
  
  
  OBJECTIVE
  to assess the prevalence of straining and its association with laxative use in free-living (FL) and institutionalised (INS) older adults.
  
  
  METHODS
  50 FL (mean age 74 years, 42% male) and 42 INS subjects (mean age 84 years, 36% male) were recruited. Straining to start and to finish defecation were prospectively recorded by subjects for 7 consecutive days in a bowel habit diary. Concurrently, the subjects recorded any laxative use during the 7 days study. Statistical analyses were performed using the Chi-square statistic.
  
  
  RESULTS
  20% of FL and 65% of INS subjects recorded taking laxatives during the study week. Of the 40 FL subjects not taking laxatives, 30 had to strain to start on 25% or less of occasions and 36 had to strain to finish on 25% or less of occasions (chi(2) = 7.2; p = 0.012 and chi(2) = 5.4; p = 0.041, respectively). In the INS group, although 64% of subjects taking laxatives had to strain on more than 25% of occasions, the Chi-square test was not statistically significant.
  
  
  CONCLUSIONS
  From our results, it seems that laxatives were used appropriately in the FL, with the majority of those taking laxatives having to strain to start on more than 25% of occasions.
authors.affiliation: Nutrition Research Centre, South Bank University, London, UK. cristinamarfilverchili@yahoo.es
authors.forename: C
authors.initials: C
authors.lastname: Marfil
authors.forename: G J
authors.initials: GJ
authors.lastname: Davies
authors.forename: P W
authors.initials: PW
authors.lastname: Dettmar
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002400:Cathartics / Q000627:therapeutic use*; D003248:Constipation / Q000188:drug therapy* / Q000503:physiopathology*; D003672:Defecation / Q000502:physiology*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008131:London; D008297:Male; D009735:Nursing Homes
chemical_list: D002400:Cathartics