New diagnostic definition for Functional Cognitive Disorder

New diagnostic criteria shine a light on early dementia mimics.


FCD is likely ubiquitous in clinical practice but may be under-diagnosed.

In a new study, UK academics and clinicians have collaborated to develop a diagnostic definition for FCD. It was an incredibly important step toward improving diagnosis, management, and research into FCD and other cognitive disorders.

This definition will allow a new phase of research into FCD as scientists can now consistently identify patients.

Dr. Harriet Ball from the University of Bristol, first author of the paper, said, “Dysfunction of day-to-day thinking processes is a feature of FCD, but it is often misdiagnosed as early dementia. We estimate up to a third of people attending specialist memory clinics have FCD. While FCD involves impairment of thinking processes, unlike dementia, it is not expected to progress. From a patient’s point of view, that is a very different prognosis and one that requires different management.”

“As clinicians, we aim to unravel the causes of early memory symptoms, and importantly, identify those that can improve over time rather than deteriorate towards dementia. Having clear diagnostic criteria for FCD will enable us to characterize the condition better and better explain it – and its prognosis – to patients and their families.”

“While some people do spontaneously recover, this is often related to how long it has gone on and how entrenched it has become. Treatment up to now has focused on the management of aspects that we know can help general, for example, cutting down medications that might be making things worse, working on better sleep patterns. Still, we’d like to test specific cognitive therapies that could prove much more successful in the future.”

Dr. Ball said the definition also had essential benefits in terms of strengthening research into dementia.

“With a clear operational definition, we’ll be better at picking the right people for trials against, for example, Alzheimer’s proteins – because if lots of people with FCD are in those trials, it is much harder to show any treatment effect against Alzheimer’s.”

The next stage for this work, which has already begun, involves assessing clinical markers and understanding the epidemiology, all of which will help build treatment studies.

Journal Reference:
  1. Harriet A Ball et al. Functional cognitive disorder: dementia’s blind spot. DOI: 10.1093/brain.awaa224
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