Cognitive function is not associated with recurrent foot ulcers in patients with diabetes mellitus a

NewsBot · Feb 27, 2009

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Cognitive function is not associated with recurrent foot ulcers in patients with diabetes mellitus and neuropathy.
Kloos C, Hagen F, Lindloh C, Braun A, Leppert K, Müller N, Wolf G, Müller UA.
Diabetes Care. 2009 Feb 24. [Epub ahead of print]

Research Design and Methods: This single centre prospective study assessed the association of cognitive function and risk for ulcer relapse in 59 patients with diabetes mellitus (age 65.1 years, diabetes duration 16.5 years, HbA1c 7.4%), peripheral neuropathy and a history of foot ulceration. Premorbid and current cognitive functions were measured (multiple choice vocabulary test (Lehrl), Number-Symbol-Test, Mosaic-Test HAWIE-R and Trail-Making-Test A and B (Reitan)). Prevalence of depression was evaluated retrospectively (diagnoses in patient files, use of antidepressive medication). Patients were re-examined after 1 year.

Results: 3 (5%) patients died during follow-up (1 of sepsis, 2 of heart problems). The remaining 56 patients developed 27 (48%) new foot ulcerations (78% minor lesions Wagner stadium 1). Characteristics of patients with and without ulcer relapse were not different. In binary logistic regression cognitive function is not predictive of foot re-ulceration.

Conclusion: Cognitive function is not an important determinant of foot re-ulceration.
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Graham · Mar 12, 2009

I wonder though how cognitive function affects the healing of an ulcer.

regards

NewsBot · Sep 22, 2022

Relationship between cognitive function in individuals with diabetic foot ulcer and mortality
Yael Sela et al
Diabetol Metab Syndr. 2022 Sep 19;14(1):133

Background: Diabetic foot ulcer (DFU) is a common diabetes mellitus (DM) complication. Individuals with DM and a DFU achieved significantly lower scores in cognitive tests than those without a DFU. We investigated whether baseline cognitive function in individuals with a DFU is a determinant of mortality.

Methods: A prospective study using data collected during a case-control study conducted in 2010-2012 whereby 90 participants with a DFU (mean age at baseline 58.28 ± 6.95 years, 75.6% male) took the paper and pencil and the NeuroTrax battery of cognitive tests. Depression was assessed, and the DFU status was evaluated. In 2020, information pertaining to participants' vital status (dead/alive) was collected and the relationship between baseline cognitive status and vital status was assessed.

Results: During a median follow-up of 6.8 years (range 0.2-9.5), 39 participants died (43.3%). Individuals alive vs. those who had died during follow-up had a higher global cognitive score at baseline (92.16 ± 10.95 vs. 87.18 ± 12.24, p = 0.045), but increased risk was not found. Individuals who were alive vs. those who had died during follow-up had statistically significantly higher baseline executive function, reaction time and digit symbol substitution test results. However, after adjustment for glycosylated hemoglobin (HbA1c), microvascular and macrovascular complications, no relationship between cognitive tests and mortality remained significant.

Conclusions: The higher mortality rate among people with type 2 DM and a DFU was not significant after adjustment for HbA1c, micro- and macrovascular complications. There may be common pathophysiological pathways to both DM complications and cognitive impairment, which may contribute to increased mortality. Further studies are warranted.
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