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Tremor Other Hyperkinet Mov (N Y). 2019 Jul 30;9. doi: 10.7916/tohm.v0.691. eCollection 2019.

Functional Movement Disorders in Elderly.

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Department of Neurology, Govind Ballabh Pant Postgraduate Institute of Medical Education and Research, New Delhi, IN.



Functional movement disorders (FMDs) have been rarely described in the elderly population.


This is a retrospective chart review of elderly patients with FMDs (onset >60 years) attending the movement disorders clinic at a tertiary care teaching institute in India.


Out of 117 patients diagnosed with FMD at our center, 18 patients had an onset after the age of 60 years. The male-to-female ratio was 10:8 and the duration of symptoms ranged from 1 day to 5 years. Social (10/18) and physical factors (5/18) with an evident temporal relationship with the onset of FMD were identified in 15 out of 18 patients. Six of them had a past history of depression, anxiety, or other psychiatric illnesses. The tremor was the most frequent phenomenology seen in 11 (61.1%) patients, followed by dystonia in seven (38.8%), choreoballism and tics in two each, and hemifacial spasm and functional gait in one each. Seven patients had more than one phenotype.


Tremor was the most frequent movement disorder seen in our patients with FMD. Surprisingly, tics (n = 2) and choreoballistic (n = 2) movements were also found in our patients with FMD, which has not been reported previously in an elderly population. Both physical and social factors were identified preceding the development of FMDs in majority of our patients.


Functional; elderly; entrainment; movement disorders; tremor

Conflict of interest statement

Funding: None. Conflicts of Interest: The authors report no conflicts of interest. Ethics Statement: This study was performed in accordance with the ethical standards detailed in the Declaration of Helsinki. This study was a retrospective chart review and all patients had provided written informed consent.

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