Prevalence, characteristics and risk factors for chronic lower-limb oedema in the older population living in the community or in an aged-care home: a systematic review

Abstract

Introduction Chronic lower-limb oedema co-occurs with multimorbidity, functional limitations and increased risk of wounds and cellulitis. Findings vary across settings and methodologies. Objectives To synthesise the prevalence, characteristics and risk factors for chronic lower-limb oedema in older adults living in the community or aged-care homes. Methods A systematic review was conducted according to PRISMA 2020 guidelines. MEDLINE, EMBASE, Scopus, Web of Science and Cochrane were searched to 25 March 2026. Eligible studies included adults aged ≥60 years in community or aged-care settings and reported prevalence, characteristics or risk factors for chronic lower-limb oedema. Two reviewers independently screened studies, extracted data and assessed methodological quality. Results Sixteen studies met inclusion criteria; 14 were conducted in community settings and two in aged-care homes. Community population-based studies estimated prevalence between 22.7% and 26.4%. Aged-care home prevalence ranged from 10.0% to 27.5% but discretionary exclusion of residents may bias estimates. Chronic lower-limb oedema commonly co-occurred with diabetes, heart disease, obesity (reported at high prevalence across studies), cellulitis and wounds. Evidence for independent risk factors was limited. Substantial heterogeneity reflected differences in study populations, sampling strategies and assessment methods limiting generalisability of findings. Methodological quality varied, particularly in population description and outcome measurement. Conclusion Chronic lower-limb oedema appears common ranging from 22.7% to 26.4% prevalence in community settings and up to 27.5% in aged-care homes. Despite potential clinical and economic burden, the evidence base, particularly within aged-care homes, remains limited. Screening may be warranted in these high-risk groups.