Dubai, United Arab Emirates (CNN) — Researchers say they have found a possible link between regular use of laxatives and a person’s risk of dementia. However, experts noted that the research is still early days and should be interpreted with caution.
According to researchers from medical institutions across China, as well as at the University of Cambridge and Harvard Medical School, about 20% of the general population and about 70% of people in nursing homes suffer from constipation, and most people with constipation are treated with one of two versions of available laxatives. without a prescription.
The study, published in the medical journal of the American Academy of Neurology on Wednesday, notes that the potential dementia association is stronger with the use of osmotic laxatives, which draw water into the stool to make it softer and easier to pass.
The other main type, stimulant laxatives, increase muscle contractions along the entire length of the stool.
The study included nearly 10 years of self-reported data from 476,219 adults aged 40 to 69 in the UK.
First, the study authors determined the participants’ health status and lifestyle factors, including their consumption of over-the-counter laxatives.
About 3.6% of the participants reported using laxatives on most days of the week during the previous four weeks.
Regular laxative users were mostly women, had low educational attainment, suffered from a chronic disease, and regularly consumed anticholinergics and opioids.
The study showed: “Symptoms of stroke, high blood pressure, depression, poor general rating of self-health, and consumption of calcium channel blockers, statins and steroid drugs were higher among regular (laxative) users compared to infrequent users.”
The researchers found that 2,187 of the participants had been diagnosed with dementia of all causes, including Alzheimer’s disease and vascular dementia, by the end of the study period.
“Regular use of laxatives was associated with an increased risk of all-cause dementia, particularly in those who used multiple types of laxatives or osmotic laxatives,” they wrote in the study.
Dementia was diagnosed in 1.3% of the participants who used laxatives regularly, while the rate was 0.4% in those who did not report regular use of laxatives.
Dr. Richard Isaacson, a preventive neurologist at the Institute of Neurodegenerative Diseases in Florida, said the findings are interesting, but only speculative.
“Further studies are warranted to have a definitive impact on clinical practice,” said Isaacson, who was not involved in the study.
The researchers offered one explanation for this finding, which begins with the composition of the microbiome, the trillions of microbes (microorganisms) that live inside the gut.
They show that the osmotic laxative has a lasting effect on the microbiome, and may affect the production of neurotransmitters needed for normal cognitive function.
They write that osmotic laxative consumption may also increase the production of enterotoxins.
Laxatives may also disrupt the epithelial barrier, which regulates the absorption of nutrients and helps deliver essential substances to the central nervous system.
Study limitations include that patient data are self-reported and may be inaccurate, and that there is limited information about potential confounding factors such as patients’ fiber intake and severity of constipation.
Dr. Ali Rezaei, director of the Gastrointestinal Motility Program at Cedars-Sinai Medical Center, expressed skepticism about the findings, saying that the study lacked a key component necessary to draw an accurate association between regular use of laxatives and dementia—namely, the amount of data.
“Laxatives change the microbiome, but we don’t have data to suggest that those changes caused by laxatives are the same changes that we see in dementia studies,” Rezaei, who was not involved in the research, explained.
“This is a huge leap (in conclusion) that would take decades of study to figure out,” he added.
Rezaei noted that the study period was not long enough to extract concrete evidence, and the participants’ baseline data did not accurately represent what he saw during his medical practice.
The study equalized the amount of participants who used laxatives regularly and the number who experienced constipation, but the two groups may not always overlap.
He also pointed out that the rate of constipation in the study was only 3%, and he said: “This simply tells me that they did not identify all patients with constipation, but only identified patients who reported using over-the-counter laxatives regularly. It is unusual to find 3% Only one of the population suffers from constipation.
Isaacson also noted the lack of participant data, particularly with regard to racial diversity. “From a health equity perspective, it is important to indicate that the specific study population was 90% white, so broader conclusions should be reserved for those based on a broader population,” he said. Diversity.
Isaacson and Rezaei came to a similar conclusion, that more research is needed and that the potential link is not strong enough to change medical practice.
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