Historical trajectory of the concepts of dementia

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  • 認知症概念の温故知新
  • ドキュメント講演 認知症概念の温故知新
  • ドキュメント コウエン ニンチショウ ガイネン ノ オンコ チシン

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Expanding our knowledge of the historical backgrounds of dementia may benefit a holistic understanding of the concept of dementia and its causative diseases.　This article aims to review the trajectory of the concepts of dementia and how dementia has come to be considered as a medicosocial problem in Japan.　The first reference to cognitive decline associated with aging appeared in the era of mythology, being described as a supernatural phenomenon that should be accepted with awe.　In the 8th Century, those who had lost resilient mental function were described as crazy and ugly.　In the 11th and 12th Centuries, “absent-minded” was often used to describe cognitively impaired elderly, and various anti-social behaviors were ascribed to this “senile insanity”.　In the 17th Century, a new term “rômô” or dotage came into use in the similar context that cognitive decline was an unavoidable physiological changes associated with aging.　In contrast, ancient and medieval medical books underlined the importance of “exogenous malignant vapors” seeping through the skin into the body, or loss of “energized blood” as the major causes of cognitive impairment and dementia.　Since the 17the century, there was a burgeoning concept that dementia is a consequence of age-related brain diseases.　In the early 20th Century, dementia came to be recognized as a result of senility （senile dementia）, atherosclerotic psychosis （vascular dementia） or Alzheimer’s disease, closing in on the current understanding of pathophysiology of dementia.

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