Relationship between depression, cognitive function and quality of life of Nigerians with diabetic foot ulcers. A preliminary controlled study

Abstract

Background. Severe negative effects of diabetic foot ulcers on health related quality of life have been documented in western studies using quantitative and qualitative methods. Aim. The aim of this study was to determine if there is a relationship between these negative effects and cognitive impairment or clinical depression. Methods. Thirty nine Nigerian adults with diabetes completed the WHO Quality of LifeBrief version (WHOQoL-Bref), modified mini mental state examination (mMMSE) and a rating scale for depression (Beck’s Depression Inventory). There were two matched groups composed of 21 subjects undergoing treatment for diabetic foot ulcers (index) and 18 subjects without foot related morbidity but with evidence of peripheral neuropathy as measured by Semmes-Weinstein 5.07(10 gm) monofilament (control). Results. Patients with diabetic foot ulcers had significantly poorer scores on domains of WHOQoL particularly in physical, psychological, overall quality of life and overall health score. There was evidence of depression in both groups with the index group more significantly depressed. There was no evidence of clinically significant cognitive impairment in either group. There was a relationship between clinical depression and negative effects of diabetic foot ulcer on health related quality of life. Conclusions. The results of this study suggest that the negative impact on healthrelated quality of life in diabetic patients with foot ulcers may be more severe than in diabetics without foot related morbidity. The negative effect did not seem to cause cognitive impairment in either group.