Neuro-Psychiatric Alterations in Patients with Diabetic Foot Syndrome

Abstract

Diabetic Foot Syndrome (DFS) is a common long-term complication of diabetes mellitus. DFS has recently been associated with adverse effects on brain function which could further impair the quality of life of these patients, as well as increase the social and economic burden, morbidity, and premature mortality of the disease. The current knowledge of neuropsychiatric alterations e.g. cognitive impairment, gait disorder, depression, and quality of life in patients with diabetic foot syndrome is summarized. The cognitive domains altered in DFS are executive function, memory, and psychomotor speed. Compared to diabetic patients without DFS, individuals with DFS present gait alterations caused by changes in several spatio-temporal parameters and lower-limb kinematics. The increased rates of anxiety and depression among patients with DFS were related to several factors, including female sex, a smoking habit, age under 50 years, and foot ulceration exceeding 7 months' duration. The role of infections and the use of preventive antimicrobial treatment need further studies regarding their effect on comorbid neuropsychiatric disorders. The care of these patients should include the prevention, detection and treatment of these neuropsychiatric disorders in order to improve their quality of life.

Keywords: Cognitive dysfunction; daily living activities; depression; gait disorders; infection; postural balance..