Chronic Pruritus Severity and Its Association with Clinical Frailty in Geriatric Dermatology Patients: A Cross-Sectional Study

Background/Objectives: Chronic pruritus is a common and distressing symptom in geriatric dermatology, often intensified by age-related changes and frailty. Frailty, reflecting physiological decline and reduced resilience, may increase itch perception, yet its link to pruritus severity remains unclear. Our study aims to evaluate the association between pruritus severity and frailty in older dermatology patients and identify related clinical and dermatologic factors. Methods: A total of 171 patients aged ≥65 years with pruritus lasting more than six weeks were included. Pruritus was measured using the Visual Analog Scale (VAS) and 5-D Itch Scale, while frailty was assessed by the FRAIL scale. Xerosis severity was rated by the Overall Dryness Score (ODS), and data on itch duration, comorbidities, and medications were analyzed. Statistical significance was defined as p < 0.05. Results: The mean VAS and 5-D Itch scores were 6.2 ± 2.6 and 12.5 ± 3.1. Itch severity increased significantly across frailty categories (p < 0.001). Strong correlations were found between VAS and itch duration (r = 0.79, p < 0.001), ODS (r = 0.66, p < 0.001), and medication count (r = 0.56, p < 0.001). Similar associations were seen for 5-D Itch (r = 0.61, 0.64, and 0.54; p < 0.001). Age and comorbidities showed no significant correlation (p > 0.05). Conclusions: Pruritus severity in older adults was associated with xerosis, frailty, and polypharmacy, while no significant association with age was observed in univariable analyses. Incorporating frailty screening, ODS evaluation, and geriatric consultation into dermatologic care may improve management and quality of life in older adults with chronic pruritus. These findings reflect associations rather than causal relationships, as the cross-sectional design does not permit inference of directionality.