IT IS TIME TO STOP USING THE WORD DEMENTIA
The American Psychiatry Association (APA) published, in February 2022, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. – DSM -5-TR ™
Whilst the authors of the section Neurocognitive Disorders – NCDs – categorise brain diseases such as Alzheimer’s as major or mild NCDs, they go on to say that:
‘The term dementia is retained in DSM-5 for continuity and may be used in settings where physicians and patients are accustomed to this term’ (p 667).
In other words, ‘dementia’ is a term of convenience.
Is ‘convenience’ an acceptable reason for continuing to use this very disparaging and damaging word?
Japan has abolished the word ‘dementia’ because of its derogative implications.
Isn’t it time to abolish the word everywhere?
There is so much inconsistency in the understanding of ‘dementia’ because it is presented – alternatively and interchangeably – as a ‘syndrome’, ‘disease’, ‘disorder’, depending on what one is reading.
The support for dementia – a training programme for carers of ‘people with dementia’ published by the World Health Organisation (WHO) – talks of dementia being a disease.
Yet, the definition of dementia by the same organisation is that of a syndrome.
The NHS also defines dementia as a ‘syndrome’.
What is the difference between disease, syndrome and disorder?
These are definitions by the free dictionary online:
Disorder | definition of disorder by Medical dictionary (thefreedictionary.com)
Disorder: disturbance of function or structure, resulting from a genetic or embryologic failure in development or from exogenous factors such as poison, trauma, or disease.
Disease | definition of disease by Medical dictionary (thefreedictionary.com)
Disease [dĭ-zēz´]:
a definite pathological process having a characteristic set of signs and symptoms. It may affect the whole body or any of its parts, and its etiology, pathology, and prognosis may be known or unknown.
Syndrome | definition of syndrome by Medical dictionary (thefreedictionary.com)
Syndrome [sin´drōm]:
a combination of symptoms resulting from a single cause or so commonly occurring together as to constitute a distinct clinical picture.
The APA’s DSM-5 categorisation of diseases such as Alzheimer’s as mild or major neurocognitive cognitive disorders seems a more appropriate description of how the mind is altered by Alzheimer’s, Lewy Body, and similar diseases. It seems an acknowledgment that ‘dementia’ is not accurate.
Why, therefore, continue to use it?