Cognitive function is not associated with recurrent foot ulcers in patients with diabetes and neuropathy.
OBJECTIVE
To study whether there is an association between cognitive impairment and the relapse rate of foot ulcers in diabetic patients and those with previous foot ulcers.


METHODS
This single-center prospective study assessed the association of cognitive function and risk for ulcer relapse in 59 patients with diabetes (mean age 65.1 years, diabetes duration 16.5 years, and A1C 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 tests A and B [Reitan]). Prevalence of depression was evaluated retrospectively (diagnoses in patient files or use of antidepressive medication). Patients were re-examined after 1 year.


RESULTS
Three patients (5%) died during follow-up (one of sepsis and two of heart problems). The remaining 56 patients (48%) developed 27 new foot ulcerations (78% superficial ulcerations [Wagner stage 1]). Characteristics of patients with and without ulcer relapse were not different. In a binary logistic regression analysis, cognitive function is not predictive of foot reulceration.


CONCLUSIONS
Cognitive function is not an important determinant of foot reulceration.
Kloos
Christof
C
Department of Medicine III, University Hospital, Jena, Germany. christof.kloos@med.uni-jena.de
Hagen
Franziska
F
Lindloh
Claudia
C
Braun
Anke
A
Leppert
Karena
K
Müller
Nicolle
N
Wolf
Gunter
G
Müller
Ulrich A
UA
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015992:Body Mass Index; D003071:Cognition; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology; D017719:Diabetic Foot / Q000453:epidemiology / Q000523:psychology*; D003929:Diabetic Neuropathies / Q000150:complications* / Q000523:psychology*; D005260:Female; D016523:Foot Ulcer / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011446:Prospective Studies; D011581:Psychological Tests; D012008:Recurrence; D012179:Retirement; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014145:Trail Making Test; D044465:White People
D000928:Antidepressive Agents