Functional movement and gait disorders: A matter of age?

Functional neurological disorders (FND) represent a significant public health challenge due to their prevalence and impact on quality of life. Functional movement disorders (FMD) and functional gait disorders (FGD) represent a large part of the broad phenotype spectrum of FND.

This study aimed to describe the clinical profiles and associated characteristics of FMD and FGD, with particular attention to age-related symptoms.

A retrospective review of medical records with standardized collection of data of FND and FMD patients from three Neurological Referral Centers was conducted from 2016 to 2024. Data collected included demographic information and clinical outcomes.

Sixty-eight patients were included with a female predominance (75.53 %). Thirty-seven had FMD (mean age 47.19 ± 18.66 years), 14 had FGD (63.0 ± 11.50), and 17 had both (49.53 ± 20.90 years). FGD were more frequent in older patients compared with FMD patients (p = 0.0046) and with patients with the mixed phenotype (p = 0.043). Tremors were the most common FMD subtype (70.3 %), while astasia-abasia was the predominant FGD phenotype (57.1 %). Fifty-three percent of patients were lost to follow-up, 20.6 % improved, and 26.5 % remained stable. Lack of physical and psychological rehabilitation was predominant in lost-to-follow-up subjects.

FND age of onset was significantly associated with phenotype, with older patients being more affected by FGD. This association may be partially influenced by societal perceptions of aging and mobility.