Functional cognitive disorder: what is it and what to do about it?
Abstract
To err is human, and it is normal to make minor cognitive errors from time to time. Some people experience persistent subjective cognitive difficulties that cause distress and functional impairment, with no underlying structural, neurodegenerative, toxic or metabolic cause. This is considered a form of functional disorder. In this article, we review functional cognitive disorder and outline its core clinical features. Patients with this are typically of working age and have a source of psychological distress, such as chronic pain, work stress or family difficulties. Its distinction from incipient dementia is difficult and usually requires interval follow-up. Pointers towards possible dementia include abnormal neuroimaging or loss of insight. Many patients accept a functional cognitive disorder diagnosis and willingly engage with psychological therapies but there is no defined optimal treatment. Functional cognitive disorder is common but under-studied; future research priorities include the development of clear diagnostic criteria and robust trials of therapeutic strategies.
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In clinical literature individuals with FCD are described as tending to rate their own cognitive abilities as being much worse than that found on objective testing and compared to their previous level of functioning.
“In clinical literature individuals with FCD are described as tending to rate their own cognitive abilities as being much worse than that found on objective testing and compared to their previous level of functioning (5).”
From A qualitative analysis of patients' day-to-day living with functional cognitive disorder (FCD). (2025) · cites this paper as [5]
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- Authors
- Pennington, C., Newson, M., Hayre, A., & Coulthard, E.
- Affiliations
- North Bristol NHS Trust (GB)
- University of Bristol (GB)
- Corresponding author
- Pennington, Catherine
- Venue
- Practical Neurology
- Publisher
- BMJ
- Published
- 2015-08-13
- Volume
- 15
- Issue
- 6
- Pages
- 436-444
- ISSN
- 1474-7758 (ISSN-L)
- 1474-7766
- OpenAlex
- W1780948983
- Cited by
- 49
- References
- 48
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 9 · 2022: 8 · 2021: 1 · 2020: 6 · 2019: 8 · 2018: 5 · 2016: 1
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Practical Neurology (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- National Institute for Health and Care Research (CL-2013-25-501)
- North Bristol NHS Trust
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- functional cognitive disorder, subjective cognitive impairment, functional disability, psychological distress, chronic pain, occupational stress, family problems, differential diagnosis of dementia, neuroimaging, loss of insight, psychotherapy, diagnostic criteria, treatment options
- MeSH terms
- Aged, Mental Disorders, Cognition Disorders, Electroencephalography, Female, Hematologic Tests, Humans, Magnetic Resonance Imaging, Middle Aged, Neuropsychological Tests, Prevalence
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