Constipation is a disorder characterized by persistent difficulty in evacuating (1). It is among the functional diseases of the intestine affecting about 20% of the world's population (2). Elderly people are more prone to constipation as there are abnormal changes due to aging, such as lack of intestinal motility, reduction in bowel movements, reduced frequency of bowel movements, diet and inadequate fluid intake, sedentary lifestyle, disease or drug use (1). The association between constipation and urinary disorders in the elderly are more frequent in individuals with overactive bladder syndrome (OAB) (3). Both intestinal constipation and overactive bladder syndrome are more prevalent in women (3). There are several questionnaires, criteria, and scales that professionals use as a form of standardization to diagnose functional constipation; among them, the most commonly used are Wexner's Constipation Score and the Rome III Criteria. It is evident that moderate to severe overactive bladder and functional constipation are common clinical conditions in the elderly, and both have an adverse influence on quality of life (3). The objective of the present study was to analyze the prevalence of intestinal constipation in older women with OAB, taking into account the female gender, age, and sociodemographic factors considered relevant for OAB and functional constipation.

This study is a cross-sectional descriptive study that seeks to analyze the prevalence of constipation in older women with OAB. Data were collected between March 2018 and October 2019 through an evaluation questionnaire. The application of the evaluation questionnaire was carried out through an interview by the physiotherapists and students from the University of Brasilia (UNB) - Faculdade de Ceilandia (FCE). For the present study, we used only the sociodemographic data, the Rome III Criteria, the Jorge & Wexner Constipation Score to assess constipation, and the ICIQ-OAB (International Consultation on Incontinence Questionnaire Overactive Bladder) to evaluate OAB. We consider critics of Rome III as a diagnosis for constipation. However, to characterize a sample, we also consider Jorge & Wexner's constipation score. The eligibility criteria were female, aged equal to or higher than 60 years, and likely urinary dysfunction, which was identified by a score similar to or greater than 8 points in OAB-V8 (Overactive Bladder, Version 8 questionnaire). Women with urinary infection, determined by a urine test, older women who had neurological impairment, who were unable to answer the survey, or who had undergone previous physiotherapy treatment were excluded. After the administration of the evaluation questionnaires, the data were tabulated and analyzed according to a descriptive statistic with the results expressed as mean, standard deviation, and percentage.

Forty-two older women met the eligibility criteria. According to the data analysis of the 42 elderly participants, 19 had constipation (45.2%), and 23 had no constipation (54.8%).
For the sociodemographic characterization of the groups of women with and without constipation, the average age, body mass index (BMI), education, pregnancy, abortion, vaginal delivery, and the score of the OAB-V8 questionnaire were evaluated. Data are presented as means ± standard deviation.
In the group of older women with OAB and constipation (n=19), age was 73.57 ± 8.66 years old, body mass index was 28.66 ± 5.03 kg/m2, degree of schooling of 1.8 ± 1.37 years at school, previous abortions were 0.47 ± 0.69, vaginal delivery was 5.0 ± 2.82, and OAB-V8 questionnaire score was 24.05 ± 7.86. 
For the group of older women with OAB but without constipation (n=23) we had: age was 69.21± 9.24, body mass index was 30.61 ± 5.69, educational level was 2.40 ± 1.14 years at school, number of previous pregnancies was 5.08 ± 3.16, number of previous abortions was 0.78 ± 0.99, vaginal deliveries was 3.60 ± 2.79 and OAB-V8 questionnaire score was 23.86 ± 6.65.

For the clinical characterization of groups of women with and without constipation, we evaluated the average of the Jorge & Wexner score variables that correspond to intestinal frequency, difficulty/evacuation effort, incomplete evacuation sensation, time in minutes in the lavatory, aid to evacuate, attempt to evacuate in hours, duration in years of constipation and abdominal pain.
Figures 1 shows the distribution of the frequency of symptoms of constipated older women, score on Jorge & Wexner questionnaire (y-axes) and the score on questionnaire ICIQ-OAB (International Consultation on Incontinence Questionnaire Overactive Bladder), that represents the OAB (x-axes).
Figures 2 shows the distribution of the frequency of symptoms of no constipated older women, score on Jorge & Wexner questionnaire (y-axes) and the score on questionnaire ICIQ-OAB (International Consultation on Incontinence Questionnaire Overactive Bladder), that represents the OAB (x-axes).

The prevalence of intestinal constipation in older women with OAB was high compared to studies evaluating such incidence in the general population. Older women with constipation presented higher complaints in all symptoms included in the constipation score of Jorge & Wexner when compared to older women without constipation. Regarding the sociodemographic profile, constipated older women had higher age, higher rates of pregnancies and vaginal delivery, and a lower level of education. However, further studies are needed to verify the prevalence and risk factors of OAB for constipation in this population.

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