Work

Cognition and quality of life in patients with a diabetes-related foot ulcer

Year: 2025

Type: article

Abstract: 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. 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. 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). 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. • Cognitive function is significantly impaired in individuals with diabetes-related foot ulcers (DFU) compared to controls with diabetes but no DFU. • Executive functioning and rote memory deficits were observed in the DFU group, with participants taking approximately twice as long to complete the Trail Making Test (TMT). • Quality of life (QoL) scores were significantly lower in individuals with DFU, with a clinically meaningful difference in EQ-5D-5L scores. • These findings suggest that cognitive impairment may be a factor which impacts on adherence to DFU treatment regimens, emphasizing the need for tailored patient education and support.

Source: Journal of Tissue Viability

DOI: 10.1016/j.jtv.2025.100913

Authors: Nada Bechara, Fiona Hawke, Jenny E. Gunton, Peta Ellen Tehan