ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition, Psychology and Brain Health
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1578181
This article is part of the Research TopicMild cognitive impairment and cognitive agingView all 9 articles
Constipation symptoms are associated with worse cognitive outcomes in older adults without dementia
Provisionally accepted
Xiaochang LIU1,2,3
Juan Zhou1,2,3Xinyan Xie1,2,3Wenzhe Zheng1,2,3
Dan Liu1,2,3
Cheng Guirong1,2,3
Feifei Hu1,2,3Junyi Wang1,2,3Cheng Cai1,2,3Jing Liu1,2,3Qianqian Nie1,2,3Shiyue Li1,2,3Dan Song1,2,3Yuyang Cui1,2,3Jingjing Zhang1,2,3
Hua Meng1,2,3Wei Tan1,2,3
Yan Zeng1,2,3*- 1Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- 2Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, Hebei Province, China
- 3Hubei Clinical Research Center for Alzheimer’s Disease, Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
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Background: Constipation is correlated to cognitive impairment; however, the association of constipation symptoms with cognitive domains remains unclear. This study aimed to investigate this association.Methods: Participants 65 and older completed neuropsychological, clinical, and laboratory examinations. Clinicians diagnosed constipation using Rome IV criteria.Multivariate logistic regression assessed the odds ratios (ORs) and 95% confidence intervals (CIs) for mild cognitive impairment (MCI) and multi-domain cognitive impairments related to constipation and its specific symptoms. Mediation analysis tested depressive symptoms' effects.Results: Constipation was diagnosed in 9,417 participants without dementia [mean (standard deviation) age: 72.0 (5.6) years], while constipation symptoms were recorded in 3344 individuals [mean (standard deviation) age: 72.6 (5.5) years]. Of the overall population, 1895 (20.1%) were diagnosed with constipation. Constipation was associated with a higher MCI risk (OR: 1.177, 95% CI: 1.047-1.323), worse performance on language (OR: 1.133, 95% CI: 1.011-1.270) and executive function (OR: 1.386, 95% CI: 1.130-1.701). A higher MCI risk was associated with constipation symptoms: bowel movements every three or more days (OR: 1.391, 95% CI: 1.011-1.914), defecation difficulty (OR: 1.278, 95% CI: 1.002-1.629), and dry stools (OR: 1.326, 95% CI: 1.027-1.711). Prolonged bowel movements increased risk of both memory and language impairment but not MCI. Defecation difficulty was associated with memory impairment (OR: 1.309, 95% CI: 1.003-1.709), dry stools with language impairment (OR: 1.396, 95% CI: 1.088-1.791), and bowel movements every other day with executive impairment (OR: 1.761, 95% CI: 1.151-2.693).Depression mediated the association of constipation with global cognitive and language function.In the non-demented stage, constipation and its symptoms were associated with MCI and multi-domain cognitive impairments. This association and depressive symptoms should be evaluated in large-scale population screening to benefit cognitive impairment management.
Keywords: Constipation, Mild Cognitive Impairment, constipation symptoms, Cognitive Domains, depressive symptoms
Received: 17 Feb 2025; Accepted: 14 Aug 2025.
Copyright: © 2025 LIU, Zhou, Xie, Zheng, Liu, Guirong, Hu, Wang, Cai, Liu, Nie, Li, Song, Cui, Zhang, Meng, Tan and Zeng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yan Zeng, Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
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