MEMORY loss is widely considered the most well-known symptom of dementia – and it’s often the first noticeable sign in the early stages of the disease.
But in recent years, research has suggested problems with thinking and memory may not always be caused by the mind-robbing disease.
While the number of people diagnosed with dementia is rising, doctors are becoming wise to a condition known as functional cognitive disorder (FCD).
It’s an under-recognised condition that’s different from dementia.
The Alzheimer’s Society explains that in FCD, cognitive difficulties with memory and thinking – particularly when the person can’t maintain attention – are down to a problem with how the brain is working, rather than to loss of brain cells.
But people with FCD may be just as troubled by memory problems as people with dementia.
The good news is, the dementia-mimicking condition has a much better prognosis – and could go away with the right treatment.
But the main problem is getting more people correctly diagnosed with FCD, as so few people have heard of it or understand it.
“This has been a totally ignored problem,” said Professor Jon Stone, an NHS consultant neurologist at the University of Edinburgh, told The i.
“People are really suffering – but this is potentially treatable.”
Dr Henk Swanepoel, Lead Neuropsychologist at Cygnet Health Care, explained FCD is underdiagnosed as it’s characterised mainly with cognitive difficulties such as memory and maintaining attention.
“It basically comes down to a problem with how the brain is working, instead of loss of brain cells,” said Dr Swanepoel.
He said the symptoms of FCD can include:
- Mental fatigue
- Often losing track while doing things or going “blank” in thinking
- A person might also lose track of conversations or frequently misplace things
- Periods of forgetting details e.g. book, holidays, films, or at times, forgetting a word
Memory problems can be present in both dementia and FCD.
But with dementia, brain tissue is permanently damaged.
With FCD, memory problems may stay the same over time or come and go, or even get better.
This is because with FCD the cognitive problems are not due to neurodegeneration.
So what is the main cause of FCD?
“Often, anxiety or depression can be a cause for poor cognition,” said Dr Swanepoel.
“However, FCD can happen without depression or anxiety, or at times can only partly explain why a person’s symptoms are causing constant problems.
“It’s also possible that symptoms can start after a mild traumatic brain injury.”
There’s currently not a lot of information available about FCD, but early research has shown a third of those aged 60 years or less to have the condition.
“Also, recent figures indicate that patients going to a memory clinic with similar symptoms, one in four don’t have dementia,” added Dr Swanepoel.
While there’s currently no cure for dementia, effective therapies, including psychotherapy, cognitive rehabilitation, metacognitive retraining or lifestyle changes can help treat FCD.
In some cases, memory problems can just be a sign of ageing…
Is it ageing or dementia?
Dementia – the most common form of which is Alzheimer’s – comes on slowly over time.
As the disease progresses, symptoms can become more severe.
But at the beginning, the symptoms can be subtle or mistaken for normal memory issues related to ageing.
The US National Institute on Aging gives some examples of what is considered normal forgetfulness in old age, and dementia disease.
You can refer to these above.
For example, it is normal for an ageing person to forget which word to use from time-to-time, but difficulting having conversation would be more indicative of dementia.
Katie Puckering, Head of Alzheimer’s Research UK’s Information Services team, previously told The Sun: “We quite commonly as humans put our car keys somewhere out of the ordinary and it takes longer for us to find them.
“As you get older, it takes longer for you to recall, or you really have to think; What was I doing? Where was I? What distracted me? Was it that I had to let the dog out? And then you find the keys by the back door.
“That process of retrieving the information is just a bit slower in people as they age.
“In dementia, someone may not be able to recall that information and what they did when they came into the house.
“What may also happen is they might put it somewhere it really doesn’t belong. For example, rather than putting the milk back in the fridge, they put the kettle in the fridge.”
