Cognitive Function Is Not Associated With Recurrent Foot Ulcers in Patients With Diabetes and Neuropathy
- Christof Kloos, MD1,
- Franziska Hagen, MD2,
- Claudia Lindloh, MD3,
- Anke Braun, MD4,
- Karena Leppert, PHD5,
- Nicolle Müller1,
- Gunter Wolf, MD1 and
- Ulrich A. Müller, MD, MSC1
- 1Department of Medicine III, University Hospital, Jena, Germany;
- 2Department of Medicine, Erzgebirgsklinikum, Annaberg-Buchholz, Germany;
- 3Practice for Diabetology, Jena, Germany;
- 4Department for Geriatrics, Hospital Bethanien, University Hospital, Heidelberg, Germany;
- 5Institute for Medical Psychology, University Hospital, Jena, Germany.
- Corresponding author: Christof Kloos, christof.kloos{at}med.uni-jena.de
Abstract
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.
RESEARCH DESIGN AND 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.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received March 9, 2008.
- Accepted February 4, 2009.
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Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2009 by the American Diabetes Association.
