Cognitive function is not associated with recurrent foot ulcers in patients with diabetes mellitus and neuropathy
- Christof Kloos, MD (christof.kloos{at}med.uni-jena.de)1,
- 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
- 2Dept. of Medicine, Erzgebirgsklinikum, Annaberg-Buchholz, Germany
- 3Practice for Diabetology, Jena, Germany
- 4Dept. for Geriatrics, Hospital Bethanien, University Hospital, Heidelberg, Germany
- 5Institute for Medical Psychology, University Hospital, Jena, Germany
Abstract
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.
Footnotes
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- Received March 9, 2008.
- Accepted February 4, 2009.
- Copyright © American Diabetes Association
