Functional Cognitive Disorder: Diagnostic Challenges and Future Directions, 2019, Pennington et al

[Andy]

Functional cognitive disorder describes patients with persistent, troublesome subjective cognitive complaints that are inconsistent with a recognized disease process, and where significant discrepancies are found between subjective and objectively observed cognitive functioning. The etiology is heterogeneous and potentially related to underlying psychological factors. Making a diagnosis of functional cognitive disorder can be challenging and there is the potential for misdiagnosis of early-stage neurodegeneration. We compared neuropsychological findings in three groups: functional cognitive disorder (FCD), mild cognitive impairment (MCI), and healthy controls. Participants were recruited from the ReMemBr Group Clinic, North Bristol NHS Trust, and via Join Dementia Research. Both the FCD and MCI groups showed elevated prospective and retrospective memory symptom scores. Performance on the Montreal cognitive assessment was equivalent in the FCD and MCI groups, both being impaired compared with the controls. The FCD group was younger than those with MCI. We discuss challenges and controversies in the diagnosis of functional cognitive disorder, alongside illustrative cases and proposals for areas of research priority.

Open access at https://www.mdpi.com/2075-4418/9/4/131

 

[Tilly]

FLUFF will be back when I have consumed enough coffee... sometime never

 

[Sid]

Never heard of this diagnostic entity. New ones springing up all the time.

 

[rvallee]

Ugh. Using the Montreal cognitive assessment, used specifically for severe dementia, shows how utterly clueless these dolts are. This is a test where it asks you identify among 3 animals which one is the camel. Come on, this isn't serious, it has nothing whatsoever to do with what we are describing. There is a huge difference between listening and hearing-and-dismissing.

Of course you're going to find a disconnect between self-reported impairment and tests if you use the wrong tests. Using the same logic you would dismiss chemo brain, a very comparable cognitive impairment, despite it having extensive clinical observation.

Here's a challenge: go away and do something more appropriate to your skills, whatever those are. Leave this to competent people.

This is not what we mean by cognitive impairment. Listen to the words that are coming out of our mouths!

 

[Mithriel]

Functional cognitive disorder describes patients with persistent, troublesome subjective cognitive complaints that are inconsistent with a recognized disease process, and where significant discrepancies are found between subjective and objectively observed cognitive functioning. The etiology is heterogeneous and potentially related to underlying psychological factors.

So significant differences between subjective and objective observations are related to underlying psychological factors. What does that say about PACE and the other studies.

 

[duncan]

They don't have the tools to measure our cognitive difficulties.

There is something frightening when a group of people have the ability to take patients' reality and fictionalize it simply because they cannot accurately measure or identify it.

I pity these people if comprehensive post-mortem brain biopsies for patients with reported cognitive deficits ever become routine.

 

[Amw66]

Is it no surprise this is from Bristol?