Dear Laird: A friend told me to stop using the word “dementia.” She said it’s demeaning. Is that true? Signed, Wordless

Dear Wordless: A doctor would never describe a patient as “demented.” Demented means crazy or insane. Why then do doctors say a patient has dementia? 

The word “demented” has been around since the 1400s and still carries the same meaning. This is part of why there’s a stigma attached to neurological conditions. That’s one reason the American Psychiatric Association (APA) has moved away from using “dementia” in its Diagnostic and Statistical Manual of Mental Disorders. 

There are other reasons for the change. Many people mistakenly think dementia is a disease, but it’s not. It’s a disorder—a collection of symptoms. To diagnose specific diseases like Alzheimer’s or Parkinson’s, more testing is required. By using the term “disorder,” the APA clarifies that dementia is not a standalone disease. 

Additionally, dementia-like symptoms often appear in the late stages of other conditions. For example, Parkinson’s disease or long-term alcoholism can cause cognitive decline, but these issues stem from the underlying disease, not a separate one. The focus of a diagnosis should be on the root cause, not just the symptoms.

The updated term is a bit of a mouthful: Major Neurocognitive Disorder, or MANDI for short, according to the Caregiver Support Foundation. If a person can no longer live independently due to cognitive problems, the term is MANDI (MA for major, N for neurocognitive, DI for disorder.) If they have significant cognitive issues but can still live independently, the term is Minor Neurocognitive Disorder, or MINDI. 

It will take a long time for us to stop using the term “dementia” in our everyday communications regarding neurocognitive matters. But as caregivers, we can help by using terms like MANDI and MINDI. Doing so can start conversations that educate others and remind them that our loved ones are still the same people they’ve always been. They are not crazy or insane. 

With some thoughtfulness in our language, we can help reduce the stigma around dementia. We can also inspire others to show kindness and support. Hippocrates once said, “It’s much more important to know what sort of person has a disease than to know what sort of disease a person has.” Let’s keep that in mind as we move forward.