Beyond the Gut: the Overlooked Impact of Constipation on Functional Mobility and Quality of Life in Community-Dwelling Elders – a Cross-Sectional Study

Abstract

Aim: Constipation is common in the elderly and may impair functional mobility. This study examined its prevalence and impact on mobility in community-dwelling elders. Methods: A total of 630 elders (340 females, 290 males; mean age 70.78 ± 4.88 years) with adequate cognitive function were evaluated. Constipation was defined via self-report according to the Rome IV criteria and quantified with the Constipation Severity Instrument (CSI). Lower limb mobility was measured using the Five-Times Sit-to-Stand Test (FTSST), while rectal pain and quality of life (QoL) were assessed using 10-cm visual analog scales. Results: Constipation was self-reported by 82.7% of participants. Compared with non-constipated elders, those with constipation had significantly prolonged FTSST times, higher rectal pain scores, and lower QoL (all P < 0.001). Correlation analysis revealed that greater constipation severity (CSI scores) was strongly associated with poorer QoL (r = 0.71, P < 0.001) and rectal pain (r = 0.87, P < 0.001), and negatively correlated with cognitive function (r = −0.14, P < 0.001). Additionally, CSI scores were positively correlated with FTSST time (r = 0.21, P < 0.001) and rectal pain (r = 0.69, P < 0.001). Conclusions: Constipation in community-dwelling elders is strongly linked to increased rectal pain, reduced lower limb functional mobility, and poorer QoL. These results support the need for integrated gastrointestinal and physiotherapy interventions, and future studies should use longitudinal and interventional designs to confirm causality and optimize treatment strategies. Geriatr Gerontol Int 2025; 25: 799–805. © 2025 The Author(s). Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.