The Link Between Laxatives and Dementia: You Need to Know

Recent studies found a link between laxatives and dementia. The evidence suggests that frequent use of laxatives, particularly in those who use multiple laxative types or osmotic laxatives, may increase the risk of dementia by more than 50%.

Even though the exact mechanism that can explain the link between laxatives and dementia hasn’t been thoroughly understood one potential explanation is that laxatives can impact the balance of microorganisms in the gut and affect cognitive function through the microbiome-gut-brain connection.

Furthermore, the association between laxative use and dementia risk might be influenced by factors such as genetic susceptibility and specific types of laxatives.

Currently, more than 55 million people have dementia worldwide, over 60% of whom live in low-and middle-income countries. Every year, there are nearly 10 million new cases.
Dementia is currently the seventh leading cause of death and one of the major causes of disability and dependency among older people globally.
Women are disproportionately affected by dementia, both directly and indirectly. Women experience higher disability-adjusted life years and mortality due to dementia, but also provide 70% of care hours for people living with dementia.

Have you ever wondered why the number of people with dementia is skyrocketing? Dementia is a scary mental health disorder.

During my time as a nurse at NHS, I provided care to people in hospitals and nursing homes who suffer from dementia among other chronic conditions. I was surprised by the high number of laxatives being prescribed and administered. The most frequently used laxatives included macrogol, docusate, lactulose, senna, glycerol, and rectal enemas. Additionally, I observed that a majority of NHS patients had some form of mental health issues. As a nurse and nutritionist, I was wondering if there is any link between laxatives and dementia studies.

Is Dementia part of the natural aging process or is it something else?

Have you ever wondered if there is any way to prevent this from happening to yourself or to the people you love most?

Dementia, a neurodegenerative disorder affecting millions globally, has been a topic of concern in the medical community. With its potential to impact cognitive function and cause progressive deterioration in a person’s ability to think, remember, and reason, researchers are constantly seeking to uncover contributing factors that may elevate one’s risk for developing dementia. One such area of investigation is the potential relationship between regular use of laxatives and increased dementia risk.

Dementia may steal memories, but it can never erase the love and impact a person has had on those around them.

Avoid excessive use of stimulant laxatives (such as bisacodyl, senna, or sodium picosulfate) if you experience frequent constipation. Prolonged use can harm the digestive system, leading to chronic constipation and damage to the nerves and muscles in the colon.

Instead, individuals should consult with a healthcare professional who can offer guidance, initially exploring alternatives such as dietary adjustments and lifestyle changes.

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Let’s start with some data first, before delving into more scientific pharmacology details.

According to CareHomeStats (2023) In the UK, there are approximately 16,700 care homes, with about 70% being residential settings and the remaining 30% being nursing homes with approximately 500,000 people residing in care homes in the UK.

This statistic displays the leading ten dispensed laxatives to treat constipation in England, in 2022, by the number of prescription items dispensed. Macrogol 3350 was the most prescribed laxative at approximately 6.8 million items in 2022.

What is the number of people living in care homes in the UK who are affected by dementia?

Around 70 % of all care home residents have dementia or severe memory problems, according to the Alzheimer’s Society.

Based on the care home population figure provided, it is estimated that 309,035 individuals residing in residential or nursing homes in the UK are affected by some form of dementia.

Recent research has found an association between the use of laxatives and dementia. This emerging topic is important for both healthcare practitioners and patients, especially those who regularly use laxatives as a part of their daily routine.

Side Effects of Prolonged Laxative Use 

There are multiple side effects of prolonged laxative use, however, the purpose of this blog post is the link between laxatives and dementia.

link between laxatives and dementia awareness

A side effect associated with prolonged laxative use is damage to the digestive system. Over time, the body may become reliant on laxatives for bowel movements, leading to a condition called lazy bowel syndrome. This can result in the weakening of the muscles in the intestines, ultimately making it more difficult for the body to naturally pass stool.

Recent research has shown a potential link between the regular use of laxatives and an increased risk of developing dementia. More studies are needed to confirm, however is important to consider the connection for long-term laxative users.

Signs Of Constipation In Dementia Patients

Constipation is a common issue faced by dementia patients, and it is crucial to identify its signs early on to prevent complications. Common symptoms of constipation in these patients include infrequent bowel movements, hard or lumpy stools, and straining during defecation. Additionally, the person may experience abdominal pain, bloating, or a feeling of incomplete evacuation. In more severe cases, fecal impaction or overflow incontinence might occur. It is essential to monitor for these signs, as dementia patients may have difficulty communicating their discomfort.

Research has shown a significant association between constipation and dementia. It has been found that dementia patients with constipation are generally older and have more severe cognitive decline. Furthermore, these patients tend to have lower water intake, which is a crucial factor contributing to constipation development.

link between laxatives and dementia
link between laxatives and dementia

How Does Dementia Affect the Digestive System

Dementia is a neurological condition that can impact various aspects of an individual’s life, including their digestive health. The brain plays a significant role in regulating the digestive system, and as dementia progresses, it may disrupt the communication between the brain and the gut, leading to changes in bowel movements and overall digestive functioning.

One of the ways dementia affects the digestive system is by slowing down the gastrointestinal tract. This can result in constipation, which is a common issue faced by dementia patients. The brain’s diminishing ability to regulate the muscle contractions needed for normal digestion can further exacerbate this problem, and in some cases, may require the use of laxatives for relief.

Additionally, dementia patients may experience difficulties with swallowing, known as dysphagia. This can lead to malnutrition, dehydration, or even aspiration pneumonia. Ensuring that a dementia patient receives proper nutrition is essential for maintaining their overall health and well-being.

Research has led to the discovery of a possible link between laxative use and incident dementia. While the underlying mechanism is not fully understood, it is believed that the prolonged use of laxatives may interfere with the gut-brain axis, potentially contributing to cognitive decline and an increased risk for dementia.

Understanding how dementia affects the digestive system is crucial for providing comprehensive care to individuals with the condition. By being mindful of the potential digestive issues that dementia patients may face and making appropriate adjustments to their diet and healthcare routines, caregivers and healthcare providers can help improve the overall quality of life for those affected by dementia

Does Constipation Make Dementia Worse

Although constipation is known to be prevalent among dementia patients, its impact on cognitive decline is still an area of debate. However, some studies suggest that constipation may indeed exacerbate the symptoms of dementia. For example, a study on dementia patients with constipation found that low liquid consumption was a predictor of constipation, and the findings support clinical recommendations to treat constipation by increasing liquid intake.

In contrast, the use of some laxatives, like magnesium oxide, has been associated with a lower risk of dementia, although this area requires further research. The bottom line is that adequately managing constipation in individuals with dementia appears to be a crucial aspect of maintaining their overall cognitive health and well-being.

Laxatives For Dementia Patients

People with dementia may struggle with gastrointestinal issues, such as constipation, due in part to a reduced ability to communicate their needs, mobility limitations, or changes in bowel habits as the disease progresses. As a result, laxatives may be prescribed to alleviate these symptoms.

However, it is essential to weigh the potential benefits and risks. Given the association found between laxatives and dementia, healthcare providers should carefully consider the use of laxatives in dementia patients. Monitoring the dosage and frequency of laxative use becomes crucial in these cases.

An alternative approach for dementia patients experiencing constipation could involve non-pharmacological interventions, such as:

  • Dietary changes: incorporating fiber-rich foods like fruits, vegetables, and whole grains
  • Hydration: ensuring adequate fluid intake
  • Physical activity: engaging in regular, gentle exercise as tolerated, like walking or chair-based exercises

Overall, the link between laxatives and dementia risk serves as an important reminder for individuals and healthcare providers to carefully consider the potential impact of long-term laxative use.

Does Miralax Cause Dementia?

Miralax, a common over-the-counter laxative, has become a topic of concern in connection to dementia. While there is no direct evidence to suggest that Miralax specifically causes dementia, a study has found that regular use of laxatives is associated with a higher risk of dementia. More research is needed to understand the exact relationship between Miralax and dementia risk.

The study mentioned above highlights the association between multiple types of laxatives, particularly osmotic laxatives, and increased dementia risk. Osmotic laxatives are often used to treat constipation and work by drawing water into the intestines to ease bowel movements. Miralax is categorized as an osmotic laxative; however, it is important to note that the increased risk of dementia may not be exclusive to this specific brand or formulation. Future research must investigate this link further to establish a clearer understanding of the connection between specific laxatives and dementia risk.

Zinc Deficiency and Cognitive Impairment

Zinc is a crucial trace element that plays vital roles in the human body, including supporting brain health and cognitive function. Research studies have revealed a connection between laxatives and dementia zinc deficiency and an increased risk of cognitive impairment, including neurodegenerative diseases such as Alzheimer’s.

There is evidence suggesting that a link between laxatives and dementia could be related to zinc deficiency. Certain types of laxatives, especially when overused, may contribute to the depletion of essential nutrients, including zinc. Given the role of zinc in supporting brain health, it is plausible that long-term laxative use could negatively impact brain function and increase the risk of cognitive decline.

Several symptoms can indicate a possible zinc deficiency in an individual, including:

  • Impaired cognitive function
  • Poor concentration and memory
  • Reduced immune system function
  • Loss of appetite
  • Fatigue
link between laxatives and dementia zinc

It is crucial to maintain an adequate intake of zinc through a balanced diet to protect brain health and minimize the risk of cognitive impairment. Foods rich in zinc include:

  • Meat and poultry
  • Seafood
  • Dairy products
  • Nuts and seeds
  • Whole grains

When considering the use of laxatives, it is vital to keep the potential impact on zinc levels in mind. To minimize any detrimental effects on cognitive health, it is advisable to consult a healthcare professional before taking laxatives and carefully follow the recommended dosage. Additionally, exploring other treatment options for constipation, such as dietary modifications, may provide a safer alternative to long-term laxative use.

Recent research in the UK has explored the potential association link between laxatives and dementia research. One such study conducted on UK Biobank participants aimed to examine the correlation between regular use of laxatives and the incidence of dementia. This investigation was sparked by the microbiome-gut-brain axis hypothesis, which suggests a possible connection between the use of laxatives and dementia.

The study analyzed a large sample of UK Biobank participants, and their findings revealed that regular use of laxatives was indeed associated with an increased risk of all-cause dementia, with a hazard ratio (HR) of 1.51 and a 95% confidence interval (CI) of 1.30-1.75. Moreover, the risk of vascular dementia (VD) was also found to be higher, with an HR of 1.65 and a 95% CI of 1.21-2.27. Interestingly, the study did not find a significant association between laxative use and Alzheimer’s disease (AD), with an HR of 1.05 and a 95% CI of 0.79-1.40. More details about this study can be found in the published article.

Another investigation focused on the association of laxative use with incident dementia and the modifying effect of genetic susceptibility. With these findings, researchers urge attention to the possible relationship between laxative use and dementia, especially in individuals with high genetic susceptibility.

It is important to note that additional research is still necessary before drawing definitive conclusions. The current studies provide valuable insights, but further investigations are essential to understand the complexities of the relationship between laxatives and dementia fully.

Dealing with constipation in dementia patients can be challenging. However, several lifestyle and home remedies can help alleviate constipation in individuals with dementia. These remedies can be particularly useful for patients who may be at risk of developing a link between laxatives use and dementia.

Dietary changes: A healthy diet rich in fiber can significantly improve bowel movements. Encourage dementia patients to consume more whole grains, fruits, and vegetables. Keep in mind that for individuals with swallowing difficulties (common in some stages of dementia), pureed fruits and vegetables can still provide the necessary fiber. Check the Nutrient-rich foods for cognitive health

Stay hydrated: Dehydration can contribute to constipation. Ensure the person with dementia consumes adequate fluids throughout the day. Offer water, juice, or warm liquids like herbal tea to encourage them to stay hydrated.

Regular physical activity: Engaging in regular physical activity helps stimulate bowel movements. Walking, even for short distances, is beneficial for people with dementia. Adapt the activity to their abilities and mobility level.

Establish a routine: Create a consistent daily routine that includes designated times for bathroom visits. Providing sufficient time and privacy can help the person feel more comfortable and relaxed, increasing the chances of successful bowel movements.

Monitor medications: Some medications can cause constipation as a side effect. Review the medications the person with dementia is taking with their healthcare provider, and discuss potential adjustments if necessary.

By incorporating these lifestyle and home remedies, it is possible to alleviate dementia-related constipation and reduce the reliance on laxatives, potentially mitigating the risk associated with their usage.

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Conclusion

In summary, constipation is a common issue in dementia patients, and early identification of its symptoms can help prevent complications and possibly slow cognitive decline. Laxatives are commonly used to relieve constipation, but recent studies suggest that there may be a link between laxative use and dementia.

Key Takeaways

  • Laxative use may be linked to an increased risk of dementia.
  • Digestive health may play a role in the development of dementia.
  • Nutritional considerations and home care strategies may help prevent or manage dementia

More research is needed to clarify the connection and establish appropriate guidelines for using laxatives, particularly in vulnerable populations like dementia patients. Increasing liquid intake and managing constipation effectively with the supervision of a healthcare professional can contribute to better outcomes for patients with dementia.

Healthcare providers need to stay informed on this emerging topic and tailor treatment plans accordingly.

Can long-term use of laxatives increase the risk of developing dementia?

Yes, there is evidence suggesting that regular use of laxatives may increase a person’s risk of dementia by more than 50%. Researchers have found that the potential increased risk is even higher when osmotic laxatives are used 1.

Does the type of laxative, such as osmotic or stimulant, impact the likelihood of dementia?

Research has found that different types of laxatives can have varying impacts on dementia risk. For example, the regular use of osmotic laxatives is associated with a higher risk of all-cause dementia compared to other types of laxatives 4.

Are older adults who use stool softeners at a higher risk for dementia?

Although some research shows a link between laxative use and dementia, it is not clear if stool softeners have the same effect. Further studies are needed to understand the potential risks and benefits of different types of constipation relief for older adults

How does treating constipation in dementia patients differ from standard methods?

Treating constipation in dementia patients may require a more cautious approach. While laxatives can be useful for some individuals, it is crucial to consider the potential increased risk of dementia, especially for those with a high genetic susceptibility. Alternative treatments, such as diet changes and lifestyle modifications, may be recommended to help alleviate constipation without further increasing the risk of dementia.

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Madelena Tapliga
Madelena Tapliga

MSc Clinical Nutritionist, accredited Nutritionist of UK from Association for Nutrition (AfN)
Clinical Lead
Herbal Medicine
MLD therapy My specialities: Malnutrition (diet advice weight gain), Weight management (weight loss, fat loss nutrition, difficulty losing weight, high cholesterol), bariatric surgery recovery and lifestyle advices, recovery post surgery, gastrointestinal and colorectal health, cardiac disease, diabetes type 2, food sensitivities, food intolerances, food intolerance testing, healthy skin, family and meal planning, nutrient deficiencies, thyroid disorders, digestive health SIBO, polycystic ovarian syndrome (PCOS), Hypochlorhydria (low acid gastric), Immune system, Arthritis, relationship with food, nutritional support, vegetarian and vegan diets, mindfulness eating, stress management, dietary advice, recipe developer, personalised nutrition. Intermittent Fasting, evidence based nutrition, sounds therapy, manual lymphatic drainage .

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