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Dementia needs a new Chinese name

In Chinese, diseases are named based on symptoms. 

So diabetes is known as “sugary pee,” while a dyslexic “has trouble reading.” Dementia derives from two Chinese characters meaning “insane” and “idiotic.”

Now Chinese psychiatrists, worried that many people with dementia are so self-conscious they won’t seek treatment, are calling for professionals and patients to adopt a new term.

“The Chinese name implies that patients are both mentally ill and severely stupid, so the stigma is doubled,” said Helen Chiu, a professor of clinical psychiatry at the Chinese University of Hong Kong and the lead author of an editorial in the International Psychogeriatrics journal. The eight doctors who signed the piece advocating a change are from China, Japan, South Korea, Taiwan, Singapore and Switzerland.

It isn’t an issue only in Chinese-speaking populations, because the Korean and Japanese languages rely on many Chinese characters. And many Asian medical names were adapted from those used centuries ago by Chinese practitioners who called illnesses after symptoms or causes, according to Jaung-Geng Lin, a professor of Chinese medicine at China Medical University in Taichung, Taiwan.

“That was the most direct and easily understood way,” said Lin, chief editor on a guide comparing Western and Chinese medical terms.

“At the time there wasn’t any consideration about the sensitivity.”

Diabetes became known as “sugary pee disease” after doctors noticed ants around patients’ urine, Lin said. In his glossary, constipation is “has difficulty defecating,” incontinence translates to “loss of excrement control” and tuberculosis is an “infection from corpses” – apparently because mortuary workers and others who handle dead bodies run a risk of catching TB from an infected person’s remains.

A legendary Han Dynasty physician named Hua Tuo gave the first formal Chinese name to dementia, according to a report by researchers from the Chinese PLA General Hospital and the University of Chinese Medicine in Beijing. Then, in the 16th Century, Ming Dynasty doctor Zhang Jingyue attributed the ailment to the misdirection of bodily energy flow, or “qi,” they wrote in the Neurobiology of Aging journal.

An estimated 44.4 million people suffer from dementia worldwide, and that’s expected to triple by 2050 with 71 percent of cases in developing countries, according to the London-based nonprofit Alzheimer’s Disease International.

In aging China, Alzheimer’s is the most common form of dementia. Its prevalence may balloon as industrialization boosts known risk factors, from pollution to diabetes.

Dementia has negative connotations even in English, members of an American Psychiatric Association work group wrote in 2012.

Doctors and dementia patients’ groups in Taiwan started in 1998 to try to persuade people to use a word meaning “loss of wisdom,” the authors wrote in the journal. The public and media now seldom use the old term, they wrote.

Japan’s government in 2004 backed a publicity campaign to encourage people to avoid the commonly used word for dementia, “chiho,” which incorporates the Chinese characters and means “disease of cognition associated with idiocy,” and to instead use “Ninchi-Sho,” which translates to “cognition disorder.” Afterward, more dementia patients began talking about their experiences in public, suggesting improvements in public perception of the illness, according to a 2011 report.