Senior man looking at digital tablet provided by clinician

Nearly a third of people being treated for early dementia may instead have functional cognitive disorder, or FCD, a manageable and possibly reversible condition.

That’s according to 25 academics and clinicians who have developed a new diagnostic criteria they say could help distinguish FCD from progressive neurological conditions, allowing clinicians to better personalize intervention.

FCD is characterized by cognitive complaints that are impairing or distressing to the patient and not better explained by other disorders, said Harriet A. Ball, Ph.D., first author of the group’s paper. It’s a common problem but underdiagnosed and often misidentified as mild cognitive impairment. This erroneously lumps it together with neurological problems, she said.

“While FCD involves impairment of thinking processes, unlike dementia, it is not expected to progress,” explained Ball, a clinical lecturer in dementia neurology at the University of Bristol. “From a patient’s point of view, that is a very different prognosis and one that requires different management.”

Treatment for FCD has focused on factors known to be generally helpful, such as reducing  certain medications or improving sleep patterns, Ball said. “But in the future we’d like to test specific cognitive therapies which could prove much more successful,” she said.

“Having clear diagnostic criteria for FCD will enable us to better characterise the condition and better explain it — and its prognosis — to patients and their families,” Ball concluded. 

Functional cognitive disorder: dementia’s blind spot” was published last week in the journal Brain.