Discussions on changing the name dementia, which means 'foolish', are virtually at a standstill.
There is a proposal to change dementia to hypocognitive disorder, brain cognitive decline, dementia, neurocognitive disorder, etc., but there are criticisms that the alternative terms are medically inappropriate or that it is difficult to expect the effect of relieving social stigma, and there is no progress in actual revision discussions.
According to the Dementia Management Act, dementia is defined as an acquired multiple disorder that interferes with daily life due to a decline in functions such as memory, language ability, judgment, and performance ability due to degenerative brain disease or cerebrovascular disease.
The two Chinese characters for dementia mean foolish. Accordingly, for a long time, some in politics and society have raised the need to change the name of dementia on the grounds that it can give a negative image to patients and their families and increase social stigma.
Since 2011, amendments to the Dementia Management Act to change the term dementia have been proposed in previous National Assembly meetings, but the law has not been revised. Currently, four amendments to change the terminology for dementia are pending in the 22nd National Assembly.
The Ministry of Health and Welfare held discussions by forming a 'Dementia Terminology Revision Council' in 2023 with experts and patient groups participating, but there were no actual results.
Major medical groups are opposing the name change, saying the proposed alternative terms lack medical clarity and could lead to confusion in the medical field.
Patient and guardian groups agree with the purpose of changing the terminology, but are concerned that the proposed alternative terms lack social consensus and reflect expert opinions.
On the 8th, the Korean Medical Association's Medical Terminology Committee (Ha Sang-won and Seo Yeon-rim) stated in a report titled 'Is Changing the Name of Dementia Appropriate' published in the Journal of the Korean Medical Association that "alternative terms such as hypocognitive disorder, dementia, brain cognitive impairment, and neurocognitive disorder have limitations in failing to capture the clinical clarity and functional standards of dementia."
It is pointed out that cognitive decline or cognitive impairment encompasses not only mild cognitive impairment that does not cause any problems in daily activities, but also subjective cognitive impairment in which objective cognitive decline is not confirmed on examination even if cognitive decline is reported, pseudodementia due to depression, and temporary delirium, making it impossible to distinguish between cognitive decline states.
In addition, 'disability' and 'deterioration' also have negative connotations, making them less acceptable to patients and guardians.
According to the report, the Korean Academy of Medical Sciences, the Korean Academy of Neurology, and the Korean Association of Physicians expressed caution or opposition to changing the medical terminology for dementia.
The Korean Medical Association officially stated its opposition last year, saying that changing the name of dementia could cause confusion in the public's perception of the disease.
The Korean Dementia Association fundamentally opposes the change, saying there is no need to change the dementia terminology, but has agreed to limit the use of neurocognitive disease or dementia to legal terms in order to advance discussions.
The report explained, “There are indications that cognitive disease and dementia may be mistaken for a single disease called a cognitive disease,” and that “even within academia, various views coexist regarding the appropriateness of the term and medical clarity.”
The report emphasized, “It is difficult to judge that a name change is appropriate just because the meaning of the existing term is negative,” and added, “The new name must appropriately reflect the clinical scope and functional characteristics, while distinguishing it from related concepts such as mild cognitive impairment or subjective cognitive decline. It must also take into account the acceptability of patients and families, understandability by the general public, and connectivity with laws, disease classification, and administrative systems.”
At the same time, he suggested that the impact of the name change should first be verified and evaluated through cost estimates and pilot projects.
The report added, “It is difficult to believe that social stigma can be resolved just by changing the name, and it is important to create an environment where patients can receive necessary treatment and social support while maintaining patient dignity,” adding, “It is desirable to prioritize evidence-based verification and social consensus and take a step-by-step approach rather than hasty wholesale revision.”
