Re-Posting: Dementia 101

Contributed by: Dennis Fortier, President, Medical Care Corporation

Due to the increased press and interest about Alzheimer's disease this week (fueled by the HBO documentary), I have re-posted this clarification of "Dementia" as a clinical entity.

Based on the various interpretations I read in the press, there seems to be some confusion about the term dementia. The DSM-IV (Diagnostic and Statistical Manual for Mental Disorders, American Psychiatric Association) provides the most commonly used criteria and defines dementia in this way:

Dementia is a clinical state characterized by loss of function in multiple cognitive domains. Diagnostic features include : memory impairment and at least one of the following: aphasia, apraxia, agnosia, disturbances in executive functioning. In addition, the cognitive impairments must be severe enough to cause impairment in social and occupational functioning.

So, in even simpler terms, being demented means that one's mental faculties are impaired to a degree that interferes with their social and occupational function. For the purpose of most discussions, it really is as simple as that.

The confusion begins when people talk about "being diagnosed with dementia" or "treating dementia". In a world of clarity, those same people would speak instead about "being diagnosed with Parkinson's Disease or with Alzheimer's Disease" which may have led to a clinical state of dementia. No one would "treat dementia", they would treat the underlying medical condition causing the impairment that we describe as dementia. It is a simple concept but I hear it confused (or read about it being confused) on a daily basis.

We don't need to detect dementia, we need to detect medical conditions that lead to dementia. We cannot treat dementia, we must treat medical conditions that cause dementia. The word dementia merely describes the extent of some person's cognitive impairment.

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