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REVISE THE DSM CRITERIA FOR DEMENTIA

Your article, “DSM Criteria for Dementia Needs Revision, Experts Say,” is timely (May; page 1). The suggestion that the official definition of dementia warrants amending fell on a welcome ear.

In 1998 at a symposium on dementia, the proceedings of which were to be published but apparently never were, I presented the following:

“None of the definitions of dementia includes a statement concerning the severity of the required memory deficit. Also somewhat illogically, severe memory impairment by itself as in Korsakoff's syndrome, is by custom not classed as a dementia. The same is true of aphasia.”

“I would recommend that dementia be defined as the product of a deficit in any of the cognitive functions, either singly or in combination, provided there resulted an inability to live independently, based on intellectual impairment. When severe, memory impairment, aphasia, abulia, etc., are disabling.”

C. Miller Fisher, MD

Massachusetts General Hospital, Boston, MA