REVIEW article
Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1665510
This article is part of the Research TopicCognitive Decline in Older Adults with Epilepsy: Mechanisms, Risk Stratification, and Therapeutic Implications.View all articles
Functional Cognitive Disorder: Diagnostic Challenges, Clinical Features, and Future Directions in a Misunderstood Condition
Provisionally accepted
Ioannis Mavroudis1
Foivos Petridis2
Katerina Franekova3
Visternicu Malina4rarinca viorica5Vasile Burlui6
Ciobica Alin5,7*Bogdan Novac8Irina Dobrin8Mihai Marian Hogas8Erica Bovari6Cristina Albert6*
Dimitrios Kazis3- 1Leeds Teaching Hospitals NHS Trust Research and Innovation Department, Leeds, United Kingdom
- 2Aristoteleio Panepistemio Thessalonikes, Thessaloniki, Greece
- 3University of Leeds Leeds Institute of Health Sciences, Leeds, United Kingdom
- 4Universitatea Alexandru Ioan Cuza Facultatea de Biologie, Iași, Romania
- 5Universitatea Alexandru Ioan Cuza din Iasi, Iași, Romania
- 6Universitatea Apollonia, Iași, Romania
- 7Alexandru Ioan Cuza University, Iași, Romania
- 8Universitatea de Medicina si Farmacie Grigore T Popa lasi, Iași, Romania
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Functional Cognitive Disorder (FCD), a condition marked by significant subjective cognitive complaints in the absence of identifiable neurological disease, is increasingly recognized as a distinct and underdiagnosed entity in clinical practice. This review synthesizes recent findings to clarify its diagnostic features, differentiate it from other cognitive syndromes such as mild cognitive impairment and dementia, and explore its psychological underpinnings. We examined longitudinal studies, meta-analyses, and clinical frameworks to identify patterns of symptom presentation, cognitive performance, and psychosocial factors. Findings reveal that FCD is characterized by inconsistent cognitive deficits, preserved functional independence, and heightened help-seeking behavior, often accompanied by anxiety, metacognitive dysfunction, and maladaptive beliefs about memory. Unlike neurodegenerative conditions, FCD follows a stable, non-progressive course and shows no evidence of conversion to dementia when accurately diagnosed. Enhanced clinical recognition and structured assessment approaches are crucial for improving diagnostic accuracy, minimizing patient distress, and avoiding unnecessary medical interventions. Further research is needed to standardize diagnostic criteria and develop targeted therapeutic strategies.
Keywords: Functional Cognitive Disorder, Internal inconsistency, Memory complaints, diagnosis, Subjective cognitive decline, Pseudodementia, metacognition, Neuropsychiatry
Received: 14 Jul 2025; Accepted: 28 Aug 2025.
Copyright: © 2025 Mavroudis, Petridis, Franekova, Malina, viorica, Burlui, Alin, Novac, Dobrin, Hogas, Bovari, Albert and Kazis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ciobica Alin, Alexandru Ioan Cuza University, Iași, Romania
Cristina Albert, Universitatea Apollonia, Iași, Romania
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.