A Review of Chronic Wounds and Their Impact on Negative Affect, Cognition, and Quality of Life

Abstract

Chronic wounds represent a substantial socioeconomic, financial, and psychological burden. We examine preclinical and clinical evidence assessing the impact of chronic wounds on negative affect, cognition, and quality of life and discuss potential mechanisms underlying the link between chronic wounds and negative affect and cognition. There is limited preclinical evidence examining negative affect and wounds, but anxiety-related behaviour has been reported in a rat incisional wound model. The incidence of anxiety and depression in people with chronic wounds varies considerably. Potential mechanisms underlying the link between chronic wounds and negative affect include the immune system, pain, metabolic dysfunction, inflammation, and vascular damage. There is a paucity of both preclinical and clinical studies examining the effect of chronic wounds on cognition, highlighting a need for more studies in this area. Research suggests that there are deficiencies in the management of anxiety, depression, and cognitive impairment in people with chronic wounds, but developing and administering therapies that target these comorbidities may have a positive impact on quality of life and wound healing. Integration of mental health and cognition screening into wound care protocols would provide substantial benefits both socioeconomically and to individuals with chronic wounds.

Keywords: anxiety; chronic wound; cognition; depression; quality of life.

FIGURE 1

Potential mechanisms underlying chronic wound‐related anxiety, depression and cognitive impairment. Poor quality of life, peripheral inflammation, and pain are potential mechanisms underlying anxiety and depression in people with chronic wounds, while inflammation, vascular damage, and metabolic dysfunction have been linked to cognitive impairment and may underlie chronic wound‐related cognitive impairment. Created using Biorender.com.