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Cognition and quality of life in patients with a diabetes-related foot ulcer
Nada Bechara1, Fiona Hawke2, Jenny E Gunton3
1Faculty of Medicine and Health, The University of Sydney, Australia; High Risk Foot Service, Blacktown Hospital, Australia; Centre for Diabetes, Obesity and Endocrinology Research (CDOER), The Westmead Institute for Medical Research, The University of Sydney, Australia.
Aim:
This study aimed to compare cognitive function and quality of life (QoL) in individuals with diabetes and a diabetes-related foot ulcer (DFU) to a control group with diabetes and no active foot ulceration.
Materials & Methods:
A cross-sectional case-control study was conducted between December 2022 and August 2024. Forty-two adults with diabetes and an active DFU were compared to forty age- and sex-matched controls with diabetes but no DFU. Cognitive function was assessed using the Trail Making Test (TMT), and QoL was measured using the EuroQol EQ-5D-5L. Statistical analyses included Mann-Whitney U tests, logistic regression, and correlation analyses to evaluate differences and associations between cognitive function and QoL.
Results:
Individuals with a DFU demonstrated significantly poorer cognitive function compared to controls, taking approximately twice as long to complete the TMT (p < 0.001). Both rote memory (TMT-A) and executive functioning (TMT-B) were significantly impaired in the DFU group. QoL scores were also significantly lower in the DFU group (p = 0.005), with a notable association between cognitive impairment and reduced QoL (p = 0.01, r = -0.29). Logistic regression indicated that longer TMT completion time was associated with 4.13 increased odds of DFU (p < 0.001).
Conclusions:
Cognitive function is significantly impaired in individuals with DFU and is associated with poorer QoL. These findings highlight the need to integrate cognitive assessments into DFU management to optimise adherence and improve patient outcomes.
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