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. 2025 Jan;22(1):e70119.
doi: 10.1111/iwj.70119.

Frailty and comorbidity in older adults with and without diabetes and chronic leg ulcer: A cross-sectional study

Burcu Duluklu  1 , John Ivory  2   3 , Aideen McElvaney  2 , Angela Bligh  2 , Marion Cahill-Collins  3 , Georgina Gethin  2   3   4 , Aaron Liew  5   6 , Duygu Sezgin  2   3
Affiliations

Frailty and comorbidity in older adults with and without diabetes and chronic leg ulcer: A cross-sectional study

Burcu Duluklu et al. Int Wound J. 2025 Jan.

Abstract

This descriptive, cross-sectional study aimed to identify whether having a chronic leg ulcer (CLU), in addition to diabetes, contributed to frailty in individuals ≥65 years old. It also explored the associations between frailty, pre-frailty and other factors. 125 participants aged ≥65 attending outpatient clinics in Ireland were categorised into three groups: (1) diabetes-only and no CLU, (2) CLU-only and no diabetes, and (3) diabetes and CLU. Frailty status was identified using the Groningen Frailty Indicator (GFI) and the Physical Frailty Phenotype (PFP). The mean age was 76.09 ± 7.31. Overall, 90 (72%) had diabetes, and 89 (71.2%) had CLU in the past 6 months. While 124 (99.2%) were frail according to the GFI, 122 (97.6%) were either physically frail (n = 40, 32%) or pre-frail (n = 82, 65.6%) based on the PFP. There was no difference between the three groups regarding general frailty status (p > 0.05). However, being aged ≥75, having CLU and having CLU in addition to diabetes were associated with frailty severity (p < 0.05). Slow gait, inability to go to the toilet and dress/undress independently were the common factors contributing to frailty. Age, comorbidities and CLU were associated with frailty severity. Incorporating multidimensional frailty screening into regular clinic visits for older adults with CLU is recommended.

Keywords: chronic leg ulcers; comorbidities; diabetes; frailty; pre‐frailty.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Frailty and pre‐frailty status of participants in diabetes‐only, CLU‐only, and diabetes and CLU groups (N = 125). CLU, chronic leg ulcer; GFI, Groningen Frailty Indicator; PFP, physical frailty phenotype.
FIGURE A1
FIGURE A1
The distribution of the chronic diseases reported by the participants (N = 125).
See this image and copyright information in PMC

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