title: Cognitive functioning among patients with diabetic foot.
abstract: OBJECTIVE
  Using diabetic foot (DF) as an indicator of severe diabetes, we aimed to investigate the cognitive profile of DF patients and the relations between cognitive functioning and both diabetes complications and comorbidities.
  
  
  METHODS
  Dementia-free patients with DF aged 30-90 (n=153) were assessed through medical records and a cognitive battery. Information on diabetes complications and comorbidities was collected via interview; glycated hemoglobin (HbA1c) was tested. Data were analyzed using robust logistic or quantile regression adjusted for potential confounders.
  
  
  RESULTS
  The mean Mini-Mental Examination (MMSE) score of patients was 24.6 (SD=3.6), and 40% had global cognitive dysfunction (MMSE ≤24). Among elderly patients (aged ≥65), MMSE impairment was related to amputation (OR 3.59, 95% CI 1.07-12.11). Episodic memory impairment was associated with foot amputation (OR 4.13, 95% CI 1.11-15.28) and microvascular complications (OR 9.68, 95% CI 1.67-56.06). Further, elderly patients with HbA1c <7% had increased odds of psychomotor slowness (OR 7.75, 95% CI 1.55-38.73) and abstract reasoning impairment (OR 4.49, 95% CI: 1.15-17.46). However, such significant associations were not shown in adult patients aged <65.
  
  
  CONCLUSIONS
  Amputation, microvascular diseases and glycemic control were associated with impaired global cognitive function and its domains among patients aged ≥65.
authors.affiliation: Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Institute of NeuroscienceAging section, Italian National Council Research (CNR), Padua, Italy. Electronic address: Anna.Marseglia@ki.se.
authors.forename: Anna
authors.initials: A
authors.lastname: Marseglia
authors.affiliation: Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden. Electronic address: Weili.Xu@ki.se.
authors.forename: Weili
authors.initials: W
authors.lastname: Xu
authors.affiliation: Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: Debora
authors.initials: D
authors.lastname: Rizzuto
authors.affiliation: Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Ferrari
authors.affiliation: Leonardo Foundation and Diabetic Foot Unit, Policlinico Abano Terme, Abano Terme, Italy.
authors.forename: Christine
authors.initials: C
authors.lastname: Whisstock
authors.affiliation: Leonardo Foundation and Diabetic Foot Unit, Policlinico Abano Terme, Abano Terme, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Brocco
authors.affiliation: Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
authors.forename: Laura
authors.initials: L
authors.lastname: Fratiglioni
authors.affiliation: Institute of NeuroscienceAging section, Italian National Council Research (CNR), Padua, Italy; Leonardo Foundation and Diabetic Foot Unit, Policlinico Abano Terme, Abano Terme, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Crepaldi
authors.affiliation: Institute of NeuroscienceAging section, Italian National Council Research (CNR), Padua, Italy; Leonardo Foundation and Diabetic Foot Unit, Policlinico Abano Terme, Abano Terme, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D003925:Diabetic Angiopathies / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D017719:Diabetic Foot / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Cognition; Diabetes; Diabetes complication; Diabetic foot; HbA1c