A task force of mental health experts responsible for updating the Diagnostic and Statistical Manual of Mental Disorders (DSM) manual has proposed changes to the way doctors diagnose Alzheimer’s and other types of dementia. The task force has proposed to  replace the term “dementia” by “major neurocognitive disorder” (MNCD). This change is based on the following rationale articulated by the task force:

This rewording focuses on decline (rather than deficit — consistent with the requirement in the basic definition of an acquired disorder) from a previous level of performance.

The previous criteria for dementia used Alzheimer’s disease as their prototype and thus required memory impairment as a criterion for all dementias. There is growing recognition that, in other neurocognitive disorders (e.g., HIV-related cognitive decline, cerebrovascular disease, frontotemporal degeneration, traumatic brain injury, etc.), other domains such as language or executive functions may be impaired first, or exclusively, depending on the part of the brain affected and the natural history of the disease.

The new definition, consistent with DSM-wide changes, focuses first on performance rather than disability.

The hope is that the removal of the word “dementia” with all its attendant baggage will allow both professional and family caregivers to more effectively care for individuals with degenerative cognitive diseases.

Words matter and dementia has become a “write-off” word in our culture. Removing it from our lexicon should help us see the person with both their strengths and their deficits and help them face the disease without ignoring their essential humanity.