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South Korea’s long-running effort to replace the Korean term for dementia has stalled after the Korean Medical Association’s terminology committee questioned whether proposed alternatives accurately describe the condition. In a report published Nov. 8, the committee argued that terms including cognitive decline, cognitive disorder and neurocognitive disorder fail to capture dementia’s clinical characteristics and the degree of impairment it causes in everyday life.
A debate over stigma and medical accuracy
The Korean word for dementia, 치매 (chimae), is written with Chinese-derived characters that both carry meanings associated with foolishness. Politicians and advocacy groups have argued that the name reinforces negative stereotypes and places an unnecessary burden on patients and their families.
South Korea's Dementia Management Act defines the condition as an acquired, multiple-domain impairment resulting from degenerative brain diseases, cerebrovascular conditions and other causes. It can affect memory, language, judgment and the ability to perform everyday activities.
Lawmakers have introduced proposals to change the terminology several times since 2011, but none has passed. Four related bills remain pending in the current 22nd National Assembly. A government-backed working group established by the Ministry of Health and Welfare in 2023 also failed to produce an agreement.
Why doctors oppose the proposed replacements
The Korean Medical Association's terminology committee, whose report was published in the Journal of the Korean Medical Association, said proposed terms such as cognitive decline, brain-related cognitive decline, cognitive disorder and neurocognitive disorder could blur important medical distinctions.
For example, the broader concepts of cognitive decline and cognitive impairment can include mild cognitive impairment, in which people may continue functioning independently. They can also encompass subjective cognitive complaints that are not confirmed by testing, depression-related symptoms sometimes described as pseudodementia, and temporary delirium.
Combining these different conditions under a single label could make diagnosis and communication more difficult, the committee said. It also noted that words equivalent to impairment and decline can carry negative connotations of their own. Terms such as cognitive disease or cognitive disorder could additionally suggest that dementia is one specific disease rather than a condition with multiple underlying causes.
Patients and advocacy groups seek a broader consensus
Medical organizations remain divided. The National Academy of Medicine of Korea, the Korean Neurological Association and the Korean Association of Internal Medicine have expressed caution or opposition to changing the name. The Korean Medical Association formally opposed the proposal last year, citing concerns that a new term could confuse public understanding.
The Korean Dementia Association has also questioned the need for a change, although it previously indicated some willingness to consider using terms such as neurocognitive disease or cognitive disorder specifically in legislation as a way to advance discussions.
Patient and caregiver organizations support the goal of reducing stigma but have raised concerns that the alternatives proposed so far lack sufficient public consensus and expert review.
The medical committee called for any replacement to clearly reflect the condition's clinical scope and functional effects, distinguish dementia from milder cognitive problems, and be understandable and acceptable to patients, families and the general public. It also said a change would need to align with medical classifications, administrative systems and existing laws.
Before adopting a new name, the committee recommended estimating implementation costs and conducting pilot programs to assess the consequences. It cautioned that changing terminology alone would not necessarily eliminate stigma, arguing that protecting patients' dignity and ensuring access to appropriate treatment and social support are more important. Any reform, it said, should proceed gradually through evidence-based evaluation and public agreement rather than a rushed legislative overhaul.
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