Characteristics
Dementia is not a disease, but a syndrome. A collection of symptoms, but with a diversity of causes.
Currently more than 60 variants are known. The common feature is that they all affect the functioning of the brain and, in particular, impair memory function. This reduces your self-reliance and ability to organize your own life.
Let’s take a look at what the DSM 5 says about dementia.
In the world of psychiatry, the DSM or the Diagnostic and Statistical Manual of Mental Disorders is very important. This is a list of psychiatric conditions and their definition and criteria. This book is the reference point for psychiatry and related professions worldwide. The first version was published in 1952 and since 2013 we have had the latest version, the DSM 5.
Surprisingly, in the most recent version the term dementia has been removed as it would be too stigmatizing. We now have new terms: minor and major neurocognitive disorder. But do know that in practice we still simply use the word dementia.
In mild neurocognitive disorder, there is deterioration in the cognitive domain. The person is forgetful, has difficulty following conversations, is sometimes confused, … but is hardly troubled by this in daily life.
Therefore, this is not dementia yet.
For a major neurocognitive disorder, we observe the following criteria:
⊙ Characteristic 1 – There is a cognitive decline relative to previous levels of functioning in one or more cognitive domains (see further).
⊙ Characteristic 2 – Cognitive impairment leads to dependence on daily activities. The person with dementia needs support with complex instrumental activities of daily living, such as paying bills, managing medication, organizing a large family party, …”My mother used to organize annual family parties with ease: shopping, sending the invitation, setting the table, preparing a three-course meal, … Now I notice that father has taken over the coordination. Mother loses the overview when too much has to be done at once.”
⊙ Characteristic 3 – The cognitive issues are not solely present during acute confusion (delirium).
⊙ Characteristic 4 – There is no other mental disorder that can better explain the cognitive problems. For example, depressive disorder or schizophrenia