Attendance at the memory clinic | More likely to attend alone (AA sign). (AA sign sensitive but not specific for ‘cognitive normality’) | Likely to attend with companion | Robust and repeated studies in single neurology-led memory clinic, more evidence needed in other sites and for older adults |
Ability to answer questions about memory impairment | Unproblematic, detailed responses of ‘memory failures’ | May not be able to answer, or if does answer likely to give generic/stock-phrase responses, such as, ‘It happens all the time’ | Two small studies, replication needed in larger population |
Ability to answer questions about biographical information | Detailed responses, sometimes more information than is required, even if closed questions are asked | May not be able to recall personal information, or will give account for why ‘not able to recall offhand’ | Two small studies, replication needed in larger population |
Ability to answer compound/multi-part questions | Able to address all parts of multi-part question, with generous detail | Unable to respond to multi-part question. Likely to require prompting to answer second or third parts | Two small studies, replication needed in larger population |
Time taken to answer questions | Answers quickly and unproblematically | Responses may take so long that companion may step in to answer question | Two small studies, replication needed in larger population |
Working memory in interaction | Aware of repetition and will preface these with ‘As I said earlier’ | Unaware of repetition or ‘second time tellings’ or other’s responses to them. Will not preface repetition with acknowledgement of this | Two small studies, replication needed in larger population |
Head turn during history taking | No evidence of head turning to companion | May turn head to companion or recruit assistance from companion in other way (see below). (Head turning sign specific but not sensitive for cognitive impairment) | Robust and repeated studies in single neurology-led memory clinic, more evidence needed in other sites and for older adults |
Interaction with companion (if present) | Likely to directly request companion (if present) to confirm what they have already said | May not be able to answer and companion will step in. Or may directly request companion assistance verbally. May give incorrect or very limited information that companion will add to or correct | Two small studies, and discourse and conversation analysis studies in geriatric outpatient clinics. Replication needed in larger population with robust measures of cognitive impairment compared with behaviour |
Companion turns at talk and participation in assessment | No direct comparison studies, but likely to be minimal companion contributions | Companion likely to talk more if person has cognitive impairment | Lack of comparison studies with those who have functional memory disorders, or studies of persons with dementia in memory clinic assessments. Further studies needed |
Who is more worried about the cognitive impairment? | Patient more worried about cognitive problems | Companion more worried about cognitive problems. Patient may not be aware of any issues | Limited directly observed evidence for particular behaviour in functional memory disorder but longstanding, robust evidence of anosognosia seen in dementia |
Humour, accounts, and face saving during history taking | Not studied specifically in formally functional memory disorder but cognitively normal individuals do not provide explanations or accounts for cognitive difficulties | Some very limited evidence, but more analysis needed | Multiple studies of varying quality. Further robust studies needed comparing degree of cognitive impairment and performance on unbiased measures with qualitative observation of behaviour |
Head turn during cognitive testing | Not studied | More likely to turn head in Alzheimer’s disease, and with more severe dementia | One study with no comparison with persons without cognitive impairment, or with FMD. Direct comparisons needed |
Humour, accounts, and face saving during formal cognitive testing | Not studied | Likely to provide various accounts and use ‘face-saving’ strategies including humour when confronted with difficulties in cognitive testing | Multiple studies of varying quality. Further robust studies comparing degree of cognitive impairment and performance on unbiased measures with qualitative observation of behaviour |
‘I don’t know’ responses during cognitive testing | Not studied | ‘I don’t know’ responses signifying lack of knowledge likely to be more common as cognitive impairment is more severe | One study, with limitations in the practical applications of findings. Further, more clinically applicable studies would be helpful |