Background: Motor and cognitive deficits and consequently mobility problems are common in geriatric patients. The currently available methods for diagnosis and for the evaluation of treatment in this vulnerable cohort are limited. The aims of the ComOn (COgnitive and Motor interactions in the Older populatioN) study are (i) to define quantitative markers with clinical relevance for motor and cognitive deficits, (ii) to investigate the interaction between both motor and cognitive deficits and (iii) to assess health status as well as treatment outcome of 1000 geriatric inpatients in hospitals of Kiel (Germany), Brescia (Italy), Porto (Portugal), Curitiba (Brazil) and Bochum (Germany).

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Background: The proportion of patients with functional movement disorders (FMD) is high in neurology clinics. We assessed the prevalence and treatment response of FMD among geriatric inpatients at a University Hospital.Methods: From July 2017 to November 2018, we captured the prevalence, demographic, clinical parameters, and response to treatment of FMD patients compared to non-FMD patients treated at the neurogeriatric ward of the University Hospital Schleswig-Holstein, in Kiel. Clinical endpoints were the Short Physical Performance Battery (SPPB) for mobility and the Barthel Index for instrumented activity of daily life (iADL).Results: The prevalence of FMD was 11% (19/175), predominantly female (74%). Nine FMD patients also had a diagnosis of either idiopathic Parkinson's disease F(N=7), dementia with Lewy bodies (N=1), or progressive supranuclear palsy (N=1). At admission, neither the SPPB nor the iADL differed between FMD and non-FMD patients. The treatment response was comparable between the groups: SPPB change was +0.3 (1.8) (mean, standard deviation) in FMD and +0.4 (1.9) in non-FMD (p=0.83); iADL change was +19 (15) in FMD and +18 (17) in non-FMD (p=0.83).Interpretation: FMD prevalence was unexpectedly high in the neurogeriatric ward of a German University Hospital. There were comparable impairments and response to multidisciplinary treatment in mobility and iADL between FMD and non-FMD geriatric patients, suggesting that specific and informed treatment provided by a multidisciplinary geriatric team is effective in geriatric FMD patients. Further studies in this underdiagnosed disorder in older age are warranted.

Geriatric medicine is a rapidly evolving field that addresses diagnostic, therapeutic and care aspects of older adults. Some disabilities and disorders affecting cognition (e.g. dementia), motor function (e.g. stroke, Parkinson’s disease, neuropathies), mood (e.g. depression), behavior (e.g. delirium) and chronic pain disorders are particularly frequent in old subjects. As knowledge about these age-associated conditions and disabilities is steadily increasing, the integral implementation of neurogeriatric knowledge in geriatric medicine and specific neurogeriatric research is essential to develop the field. This article discusses how neurological know-how could be integrated in academic geriatric medicine to improve care of neurogeriatric patients, to foster neurogeriatric research and training concepts and to provide innovative care concepts for geriatric patients with predominant neurological conditions and disabilities.