to investigate the association of diabetes and its duration with frailty and evaluate the moderating effect of sex on that association in older adults.

This cross-sectional study used data from the third visit (2017–2019) of the Estudo Longitudinal de Saúde do Adulto ( ELSA-Brasil), a multicentre cohort of Brazilian civil servants. The data included were from 4886 participants aged ≥ 60 years. Diabetes was identified on the basis of self-reported diagnosis or laboratory test values. Frailty was evaluated on frailty phenotype criteria. Associations were estimated by way of multinomial regression models.

Adjusted final models showed that older adults classified as having diabetes were 116% more likely to show frailty, and 27% more likely to show pre-frailty, than persons without diabetes. Individuals with a diagnosis before baseline and those with that diagnosis at baseline or during follow-up until visit 3 were, respectively, 145% and 92% more likely to be classified as frail, and 35% and 21% more likely to be classified as pre-frail, than individuals without diabetes. No modification by a multiplier effect of sex was observed in the final models.

Older adults with diabetes returned greater odds of pre-frailty and frailty, and the odds were even greater in those with longer times since the diagnosis of diabetes, but sex did not modify those associations. These findings endorse the need for more frequent screening of older adults with diabetes with a view to early prevention and/or intervention.