Abstract
Background: Chronic diarrhoea affects 10% of the population and can be due to several causes. Prevalence data for the most vulnerable older adults, those living in aged care, is sparse.
Aim: To investigate the prevalence of chronic diarrhoea for residents living in New Zealand residential age care facilities (RACFs) and associations with medication use.
Summary: An observational study of New Zealand RACFs for three months in 2021 was conducted. It included bowel motion, anthropometric, medication and quality of life (QOL) data for 2411 older adults. Data were analysed using independent two-sample T-tests and chi-square tests. Prevalence of chronic diarrhoea was determined using the Rome IV criteria; at least 25% of bowels motions being type 6 and 7 on the Bristol stool chart.
Chronic diarrhoea was experienced by 618 (25%) of residents. Polypharmacy, defined as greater than five medications daily, occurred more frequently in residents with diarrhoea (84%) than residents with a normal bowel state (48%) (p<0.001). Laxatives were administered to 66% (404/618) of residents with chronic diarrhoea, 37% of which were charted two or more different types. Residents experiencing diarrhoea and administered laxatives were more likely to have lower mood (18% vs 12%), be at risk of pressure injuries (13% vs 4%) and less likely to enjoy time with friends and family (62% vs 80%) than residents without diarrhoea (all p <0.001). Comparing rest home residents only, who are likely more independent, the residents with diarrhoea taking laxatives continued to have lower QOL measures and were more likely to experience weight loss than those with normal bowel motions (46% vs 26% p <0.001).
Discussion: Chronic diarrhoea affects a quarter of aged care residents and is likely associated with laxative use. It is negatively associated with QOL, mood and pressure injury risk, irrespective of the level of care.