Functional neurological disorder (FND) is a common condition, but there remain substantial gaps in our understanding of its effects, particularly on severity of disability and health status.

To characterise disability, quality of life and psychological and somatic symptom comorbidity in individuals with FND attending a specialist multidisciplinary clinic in Australia.

We conducted a cross-sectional analysis of patients assessed at an FND clinic in Sydney, Australia, between August 2022 and February 2025. We assessed disability (World Health Organization Disability Assessment Schedule (WHODAS 2.0)), health-related quality of life (EQ-5D five-level version (EQ-5D-5L), 36-Item Short Form Health Survey), psychological distress (Depression Anxiety and Stress Scale-21, Kessler Psychological Distress Scale (K10)) and somatic symptom severity (Patient Health Questionnaire-15 (PHQ-15)).

The cohort (N = 105) was predominantly female (74.3%), with a mean age of 35.4 (s.d. = 13.3) years. Functional seizures (46.7%) and functional weakness (45.7%) were the most common presentations. Only 33.7% were employed; 42.9% were unable to work because of FND. The average delay from diagnosis to clinic assessment was 356 days (s.d. = 463). WHODAS 2.0 scores indicated high levels of disability, exceeding international norms for both physical and mental illness. EQ-5D-5L scores were low, with 15.8% reporting a health state rated as ‘worse than death’. Psychological distress and somatic symptom severity were high: 49.5% scored in the K10 ‘very high’ range and 54.5% had high PHQ-15 scores.

FND is associated with significant functional disability, poor quality of life and high levels of psychological and somatic symptom comorbidity. Delays in accessing appropriate care and high rates of vocational disruption highlight the need for earlier diagnosis and better access to integrated, multidisciplinary FND services in Australia.

Many studies document cognitive decline following specific types of acute illness hospitalizations (AIH) such as surgery, critical care, or those complicated by delirium. However, cognitive decline may be a complication following all types of AIH. This systematic review will summarize longitudinal observational studies documenting cognitive changes following AIH in the majority admitted population and conduct meta-analysis (MA) to assess the quantitative effect of AIH on post-hospitalization cognitive decline (PHCD).

We followed Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Selection criteria were defined to identify studies of older age adults exposed to AIH with cognitive measures. 6566 titles were screened. 46 reports were reviewed qualitatively, of which seven contributed data to the MA. Risk of bias was assessed using the Newcastle–Ottawa Scale.

The qualitative review suggested increased cognitive decline following AIH, but several reports were particularly vulnerable to bias. Domain-specific outcomes following AIH included declines in memory and processing speed. Increasing age and the severity of illness were the most consistent risk factors for PHCD. PHCD was supported by MA of seven eligible studies with 41,453 participants (Cohen’s d = −0.25, 95% CI [−0.02, −0.49] I2 35%).

There is preliminary evidence that AIH exposure accelerates or triggers cognitive decline in the elderly patient. PHCD reported in specific contexts could be subsets of a larger phenomenon and caused by overlapping mechanisms. Future research must clarify the trajectory, clinical significance, and etiology of PHCD: a priority in the face of an aging population with increasing rates of both cognitive impairment and hospitalization.