Age Range in Functional Neurological Disorder
FND generally affects young and middle-aged adults, with the typical age range spanning from adolescence through middle age, though cases can occur across the entire adult lifespan including elderly patients. 1
Typical Age Demographics
The primary affected population consists of young to middle-aged adults, representing the most common age group presenting with FND symptoms 1, 2
FND can present across the entire adult age spectrum, from adolescence (16 years and older) through elderly populations, though prevalence peaks in younger age groups 3, 4
The disorder is not restricted by upper age limits—elderly patients can and do develop FND, though this represents a smaller proportion of cases 3, 4
Clinical Implications for Age-Related Diagnosis
In elderly patients presenting with neurological symptoms, FND should not be the first diagnostic consideration—structural pathology, neurodegenerative disease, and vascular etiologies must be excluded first given the higher baseline risk of these conditions in older populations 5
The diagnostic approach requires particular caution in patients over 65 years, as comorbid neurological conditions become increasingly common and can coexist with or mimic FND 3
Among the oldest old (≥90 years), determining etiology of neurological symptoms becomes especially challenging, as multiple pathologies frequently coexist 3
Age-Specific Diagnostic Considerations
Sudden onset of symptoms over days to weeks in elderly patients should prompt investigation for structural causes (cerebral venous thrombosis, subdural hematoma, stroke, autoimmune encephalopathy) rather than presuming FND 5
The time course of symptom development helps distinguish FND from age-related neurodegenerative conditions—FND typically has acute or subacute onset, while dementia syndromes progress insidiously over months to years 3, 5
Performance status and frailty assessment become increasingly important in older adults when considering treatment approaches, as physiological reserve decreases with age 3, 6
Treatment Considerations Across Age Groups
The consensus recommendations for FND treatment (multidisciplinary rehabilitation, physical therapy, occupational therapy, and psychological interventions) apply to adults aged 16 years and older, with potential transferability to adolescent populations 3, 7
Physical rehabilitation focusing on retraining normal movement patterns through distraction techniques remains the cornerstone treatment regardless of age 3, 7
Cognitive-behavioral therapy serves as the psychological treatment of choice across all adult age groups with FND 7