Constipation is frequently dismissed as a benign or inevitable physiological consequence of aging, but for the elderly, it is an important health challenge with significant health and economic implications.
A recent Socio-Economic Assessment (SEA) conducted by the IPA sheds light on how targeted nutritional approaches, specifically the expanded use of probiotics, could help address some of the burden associated with the condition and relieve the economic weight on European healthcare systems.
Understanding the broader impact of constipation in older adults
Constipation is exceptionally prevalent among older adults, driven by reduced mobility, polypharmacy, and various comorbidities.
Research suggests that constipation may be associated with broader health implications: data from a UK Biobank study of over 400,000 participants reveals that individuals with constipation are 2.7 times more likely to develop heart failure and 1.6 times more likely to face acute coronary syndrome compared to those without the condition. Among people with hypertension, the risk of major adverse cardiac events (MACE) is increased by 34%, compared to their constipation-free counterparts.
In addition to its impact on individual wellbeing, constipation is associated with a significant economic burden for care institutions.. The annual cost of managing constipation in care homes is estimated at €2,107 per affected resident. The bulk of this expense does not stem from pharmaceuticals, which account for €408, but rather from the €1,699 associated with the additional staff workload required to manage the condition and its complications.
Exploring the role of probiotics
Extensive research demonstrates that the use of specific probiotic strains, such as Bifidobacterium and Lactobacillus, can significantly improve stool frequency and quality, even in severely immobilized elderly patients. In frail care home residents, regular consumption of fermented milk or yoghurt containing these strains has been shown to effectively normalize bowel function with no adverse side effects.
Crucially, a key study by Flach et al. highlighted in the assessment found that probiotic use among institutionalized older adults was associated with a reduction in the prevalence of constipation from 42% to 30%. This represents a relative reduction of 28%.
The economic opportunity
For healthcare providers and policymakers, this 28% reduction translates directly into significant financial savings. By including probiotics into standard dietary care, a typical care home with 100 residents could save between €8,000 and €25,000 per year. The upper estimate assumes a cost-neutral substitution strategy, such as replacing standard dairy products with probiotic alternatives.
On a macroeconomic scale, the assessment reveals a potential economic impact: expanding the use of probiotics to reduce constipation among elderly populations at home and in care facilities could generate a total economic benefit of €1.4 billion. This figure, expressed in 2025 prices, reflects estimated savings associated with lower medication use and reduced staff workload.
The path forward
For healthcare stakeholders, policymakers, and health-sector businesses, the assessment provides valuable insights. While probiotics are not intended to address all aspects of bowel function, they provide a highly effective, cost-efficient tool to manage a widespread condition.
By adopting proactive nutritional strategies, healthcare systems can improve the quality of life for the elderly and mitigate cardiovascular risks, with potential economic implications estimated at over €1 billion under the assumptions considered in the assessment.
A visual summary of the key insights
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Download a ready-made slide deck to present the key concepts from this article
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Access a comprehensive dossier summarizing the latest data on probiotic use.
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Read the full Socio Economic Impact Assessment (SEA) on Probiotics in Europe
