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Delirium, a form of acute brain failure, exhibits a high incidence among older adults. Recent studies have implicated frailty as an under-recognized complication of diabetes mellitus. Whether the presence of frailty increases the risk of delirium/cognitive impairment among patients with diabetic kidney disease (DKD) remains unclear. From the longitudinal cohort of diabetes patients (LCDP) (n=840,00 in Taiwan, we identified adults with DKD, dividing them into those without and with different severities of frailty based on a modified