Friday, March 10, 2017

APA Using NCD not Dementia

Photo by Keoni Cabral.
If the Sapir-Whorft theory is to be believed, the language we use shapes our reality.

As a gerontologist, I am interested in the labels that people use to describe older adults, since language can filter how we see people and treat people. Sometimes these filters are ageist.

Over time, people have used an array of terms to describe neurological and cognitive problems as experienced by older adults.

Some might remember that the word "senile" was prevalent in the early 20th century.

In the last few decades, people have switched to using the word "dementia," but it's very broad. It's used to describe an array of neurological or cognitive problems.

In addition to being too broad of a term, the word "dementia" is related to the word "demented," which means "insane."  For these and other reasons, the American Psychological Association (APA) scrutinized the origins of "dementia"-- which original meaning is tied to "madness" -- and in 2013 introduced a new term in the newest edition of DSM-V, their diagnostic manual.

Neurocognitive Disorders (NCD)

Read APA's 2013 announcement of this new term and its relationship to dementia. 

"Neuro" refers to the physical brain.

"Cognitive" refers to the thought processes within the brain.

The term "disorder" recognizes that there is a medical cause for problems residing in the brain or thoughts.

Furthermore, disorders are categorized as "major" or "minor" NCD.

Professionals such as neurologists, psychiatrists, and psychologists received officially notification of this new term in the May 2013 publication of the APA's Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5).  This was just one of many changes.

However, the catalyst for this change took shape in 2008 as a result of an APA workgroup.

Dementias, such as those addressed by the Alzheimer's Organization,  are not the only type of disorders falling under this new umbrella term NCD.

For example, problems due traumatic brain injury (TBI) and problems due to advanced HIV are also types of neurocognitive disorder.

I first encountered the term NCD while reading the introduction to Marc Agrogin's 2015 book, The Dementia Caregiver: A Guide to Caring for Someone with Alzheimer's Disease and Other Neurocognitive Disorders.  

I picked up his 2015 after reading his 2011 book How We Age.

Doctors and hospitals must now use DSM 5 classification systems in order to file insurance, so NCD is becoming established in those realms.

While medical researchers and clinicians might be using "neurocognitive disorder" to describe various disorders of the brain/mind, most lay people, including support groups, persist in using the more recognized--and shorter--term "dementia."


Cognitive Changes: The Usual Suspects
Another Marc Agronin book: How We Age: A Review 


  1. If coding with the DSM means more medicare/insurance coverage all the better. It is interesting to hear diseases take on name changes.

    1. I hope this renaming does increase coverage. I'm not sure. It seems the impact is greater on research perspectives. We'll have to see. I remember when dementia used to be called "senility."

  2. Very interesting. good to know!

  3. My Mother had dementia. I don't care what they call it, just hope they find a cure or something to help those that have it. It is very hard for the one who has it...and the family....

    1. Renee: I am sorry to hear that your mother had dementia. It's so hard on the person and their family. Yes, I hope that medical researchers do find a cure. It's such a devastating disease.

  4. I imagine this will cause all types of headaches until everyone is on the same page, but at least it seems like a step in the right direction.