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Fewer cognitive resources found in adults with diabetic foot ulcers
Self-treatment challenges are more often found in adults with diabetic foot ulcers compared with those with diabetes alone due to lessened possession of cognitive resources, according to study findings published in Diabetes Care.
“These findings indicate that participants with [diabetic foot ulcers] in this study were challenged with more severe cognitive difficulties compared with the participants without this complication,” the researchers wrote. “It should be emphasized that the cross-sectional design limits the ability to draw definitive conclusions about causality.”
In the case-control study, Rachel Natovich, PhD, of the department of public health, faculty of health sciences at Ben-Gurion University of the Negev in Israel, and colleagues evaluated 99 adults with diabetic foot ulcers (cases) and 95 adults with type 2 diabetes (controls) matched for diabetes duration and sex to determine whether cognitive profiles differ between the two groups. Participants underwent extensive neuropsychological evaluation using computerized neuropsychological battery, digit symbol and verbal fluency tests. Memory, executive function, reaction times, attention, psychomotor abilities and estimated premorbid condition and standardization for age and education were computed to determine a global cognitive score.
Lower cognitive scores in all tested cognitive domains were found among cases compared with controls (P < .001); this was maintained after adjustment for possible confounding factors including smoking status, HbA1c level, depression symptoms and macrovascular disease.
No differences existed for estimated premorbid cognitive abilities between the two groups. A significant difference was found between precognitive and current cognitive abilities among cases, whereas it was stable in controls.
“The present findings demonstrate what our research team has called ‘The [diabetic foot] person’s paradox:’ more challenges but fewer cognitive resources,” the researchers wrote. “The results imply that ‘[diabetic foot]’ may refer not only to the physical condition but also to a more generalized complex state involving significant cognitive changes as well. Considering the increased risk for medical complications and the unique challenge that individuals with [diabetic foot ulcers] present to health providers, we feel that it is important to screen the cognitive status of these patients regularly and to take cognitive abilities into consideration in treatment-planning recommendations and follow-up.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.