Why Do We Need to Abolish the Terms “Dementia” and “Neurodegenerescence ?” Plaidoyer pour l'abolition du mot « démence » et autres terminologies apparentées En Fr

Résumé En

Objectives – This article set put to explore the consequences of the predominant use of pejoratively connoted neuropsychiatric terminology relating to Alzheimer's Disease (AD) (dementia, neuro-degeneration) although there are other more neutral terms. Method – To explain the pejorative dimension, etymology, and also the history of these neuro-psychiatric terms, are explored. Alongside, the authors underline recent evolutions in geriatrics concerning the contributions of neuropsychology and the neurosciences in research and care provision for AD. Results – At the start of the 21st century late neurocognitive disorders (senile dementia) have been attached to AD (pre-senile dementia) on account of their neuropathology profiles. Pre-senile dementia has become pandemic, and entails numerous economic challenges linked to dependency. It is all the more stigmatising because it is associated with complete and irreversible decline, in line with the generic language – dementia or neuro-degeneration – used to refer to it. Discussion – The authors underline the use of other terms – "evolving neurological illness", or "neurocognitive disturbances" – as a necessary but insufficient condition to put a stop to this stigmatisation. Alongside, they report on the interest of global, humanistic approaches to the patient's experiences. What they have to say is not always adequately heard on account of their evolving cognitive disorders, and it is the families that are heard. Conclusion – While the neuro-psychological approach has had considerable impact on improving understanding AD and other disorders, a global, humanistic approach nevertheless remains essential for patients with this disease, so as to promote their role as active protagonists on their own care trajectory. The authors thus underline the value of in-depth ethical reflection, integrating present knowledge and present practices in the accompaniment of patients.