Chronic constipation and diarrhea are associated with depression in the elderly: Insights from a large cross-sectional study

Abstract

Abstract Background: This study was to investigate the relationship between chronic constipation, diarrhea, and depression among the elderly, as the extent of their association remains elusive despite the well-established impact of gastrointestinal symptoms on depression. Methods: Cross-sectional analyses were conducted using data from the 2005-2010 U.S. National Health and Nutrition Examination Surveys (NHANES), focusing on adults aged 60 and above with a sample size of 4878. Depressive symptoms were measured using Patient Health Questionnaire 9 (PHQ-9) scale. Information about chronic diarrhea or constipation was retrieved from the bowel health questionnaire. Multivariable weighted logistic regression analysis models were employed to estimate the relationship between gut health and depression status, adjusting for potential confounders (e.g., age, gender, race, education, marital status, education level, smoking status, drinking habits, and medical history). Results: Probable depression (PHQ-9≥10) and depressive symptoms (PHQ-9≥5) were more prevalent among elderly individuals with diarrhea or constipation than among those without them (P <0.05). After adjusting for all-cause, the elderly with chronic diarrhea were more likely to have significant increases in their scores for several subtypes of depressive symptoms (P <0.05, six out of nine depressive symptoms). We observed a significantly positive correlation between patients with chronic constipation and the depressive symptoms for low mood/despair, appetite, and lack of concentration (P <0.05). Conclusion: The elderly with depressive symptoms (PHQ-9 ≥5) may be associated with chronic constipation and diarrhea based on a nationally representative sample of the elderly in the U.S. from 2005 to 2010. These findings suggest that elderly individuals experiencing chronic diarrhea and constipation may have a higher prevalence of psychological depression symptoms.