John T O’Brien, Michael J Firbank, Karen Ritchie,, Katie Wells, Guy B Williams, Craig W Ritchie, Li Su
Journal of Neurology, Neurosurgery & Psychiatry. 2019
Individuals with a higher likelihood of developing Alzheimer’s disease dementia in the future, as predicted by their mid-life CAIDE score, show more shrinkage of brain volume, measured over the course of two years.
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When someone attends a memory clinic because of problems with their memory or thinking, doctors will carry out a variety of tests to try to determine the underlying cause. These tests often place much focus on investigating the presence of progressive diseases of the brain which can cause dementia. A recent publication however reports that, for a significant number of people, a different type of brain disorder could be responsible for their symptoms. Functional cognitive disorders can cause symptoms which, on the surface, may appear quite similar to those of progressive brain diseases. Functional cognitive disorders are not always as well recognised among researchers and healthcare professionals however diagnosing these disorders accurately can be of crucial importance to the care and wellbeing of patients. Dr Laura McWhirter has recently led a large-scale review which brings together all the existing evidence on functional cognitive disorders. Here, Laura provides us with an In Brief summary of key findings from the review:
► This study brought together results of 249 other research studies. The study was done by researchers at the University of Edinburgh.
► People who go to their doctor with memory problems are often worried about dementia.
► In dementia, memory and thinking problems get worse and worse over time because of brain disease. Alzheimer’s Disease is one example of a brain disease that can cause dementia.
► However, there are a lot of other causes of memory and thinking problems.
► People with Functional Cognitive Disorder (FCD) have memory and thinking problems which are distressing and which stop them from doing things. However in FCD these problems are the result of changes in how the brain is working and not brain disease.
► We found that 24% of patients with memory problems attending specialist ‘memory clinics’ were likely to have FCD.
► FCD is sometimes overlooked by doctors and researchers. A lot of dementia research is about finding brain disease and doesn’t pay much attention to other important causes of serious memory and thinking problems, like FCD.
► Some people with FCD have been told that they are ‘worried well’. Other people with FCD have been told, incorrectly, that they have a higher than normal chance of going on to get dementia.
► More research is needed so that we can get better at diagnosing and treating Functional Cognitive Disorder.
Article Citation
McWhirter, L., Ritchie, C., Stone, J. and Carson, A., 2019. Functional cognitive disorders: a systematic review. The Lancet Psychiatry.
Laura McWhirter is a Neuropsychiatrist and Baillie Gifford Clinical Research Fellow with the Centre for Dementia Prevention, Centre for Clinical Brain Sciences at the University of Edinburgh.
