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. 2022 Mar 31:14:789190.
doi: 10.3389/fnagi.2022.789190. eCollection 2022.

Functional Cognitive Disorder Presents High Frequency and Distinct Clinical Profile in Patients With Low Education

Wyllians Vendramini Borelli  1   2 , Priscylla Nunes de Senna  1 , Wagner Scheeren Brum  3 , Artur Francisco Schumacher-Schuh  1   4 , Eduardo R Zimmer  2   3   4 , Márcia Lorena Fagundes Chaves  1 , Raphael Machado Castilhos  1
Affiliations

Functional Cognitive Disorder Presents High Frequency and Distinct Clinical Profile in Patients With Low Education

Wyllians Vendramini Borelli et al. Front Aging Neurosci. .

Abstract

Introduction: Functional Cognitive Disorder (FCD) is a non-degenerative, common cause of memory complaint in patients with high educational levels. FCD has been insufficiently described in individuals with low education. Here, we investigated the frequency of FCD among individuals with low education.

Methods: We analyzed retrospectively all new referrals from primary care to a tertiary memory clinic from 2014 to 2021. Final diagnosis, diagnostic work-up, clinical and cognitive testing data were compared between FCD and other diagnoses, grouped as Neurodegenerative Disorders (NDD). A regression model was used to assess the effect of education on the diagnosis. Data is shown in Mean [SD].

Results: A total of 516 individuals (70.76 [10.3] years) with low educational attainment (4.5 [3.94] years) were divided into FCD (146, 28.3%) and NDD. Compared with NDD, FCD patients showed lower age at presentation (66.2 [9.4] vs. 72.6 [10.2], p < 0.001), higher Mini-Mental State Examination (MMSE) scores (22.4 [6.2] vs. 14.7 [7.8], p < 0.001) and Geriatric Depression Scale (GDS) scores (7.4 [5.4] vs. 5.3 [3.7], p = 0.0001).

Discussion: Surprisingly, FCD was the most frequent diagnosis in a low educational setting. However, education was not associated with FCD. Individuals presenting FCD showed a distinct clinical profile, including younger age and higher depressive scores. Strategies to identify FCD in primary care settings may benefit both patients and healthcare systems.

Keywords: Alzheimer’s disease; cognitive complaint; dementia; major depression; public health; subjective cognitive decline; subjective memory impairment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Frequency of diagnosis. The circle represents the frequency of diagnosis in our sample (n = 516), from 2014 to 2020. FCD, functional cognitive disorder; AD, Alzheimer’s disease; MCI, mild cognitive impairment; VD, vascular dementia; bvFTD, behavioral variant frontotemporal dementia; LBD, lewy bodies dementia.
FIGURE 2
FIGURE 2
Number of new appointments in the memory clinic studied. Relative percentages represent the number of diagnoses of FCD divided by total new appointments of the corresponding year. FCD, functional cognitive disorder; MCI, mild cognitive impairment; NDD, neurodegenerative disorders. *Decrease in total number of appointments related to Coronavirus disease pandemic.
See this image and copyright information in PMC

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