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Introduction Functional neurological disorder (FND) can present later in life, but research on older adult patients and their treatment outcomes remains limited.Objectives This service evaluation examined older adults (≥ 60 years) who participated in the Queen Square FND rehabilitation programmes. It assessed demographics, patient engagement, and clinical outcomes, including symptom improvement and functional recovery. The study also explored whether older adult patients differed from the ‘typical’ FND patient profile and whether they benefitted from MDT therapy programmes.Methods A retrospective audit of records from the National Hospital for Neurology and Neurosurgery’s FND rehabilitation service (2021–2024) included patients aged ≥ 60 years who attended the 5-week outpatient or 4-week inpatient MDT programmes. One patient was excluded from the sample after it became apparent that her symptoms were not due to FND during admission. Data from electronic records and questionnaires covered demographics (age, gender, comorbidities) and clinical outcomes (PHQ9, GAD7, WSAS, COPM).Results The audit included 44 older adults, representing 11% of the total cohort during the evaluation period. Among them, 18 (42%) were inpatients, and 26 (57%) were outpatients. The mean age was 66 years, with a female-to-male ratio of 28:16. The mean age of symptom onset was 58 years, and the mean symptom duration was 8 years (median: 5 years, range: 1–42 years).Depression was identified in 25 patients (56.8%), anxiety in 21 (47.7%), panic attacks in 7 (16%), and PTSD in 6 (13%). Pre-existing neurological comorbidities were present in 21 patients (47%).Movement disorders were the most common functional symptom (77%), followed by pain (34%), cognitive symptoms (27%), non-epileptic seizures (23%), and weakness (29.5%). Frequent symptom combinations included movement disorder with pain (8 cases) and fatigue with pain (7 cases).Clinical outcomes showed improvements across all measures. Most patients reported moderate positive changes in mood and functional performance outcomes. Inpatients generally started with higher severity scores and experienced greater functional improvements. Further data analysis will be presented.Conclusion Older adults with FND demonstrated significant improvements in symptoms and functional outcomes, supporting the efficacy of inpatient and outpatient MDT programmes. These findings highlight the complex presentation of FND in this population and the potential for meaningful recovery. Further research with larger cohorts is needed to optimize treatment strategies.