Dissonant dementia: neuropsychiatry, awareness, and contradictions in cognitive decline

This paper presents an analysis of contemporary neuropsychiatric meaning-making regarding dementia, encompassing distinct beliefs, practices and objects, and the peculiarities of its fragmented public manifestations. First, some core neuropsychiatric beliefs are discussed, arguing that the designation of those beliefs as exceptional truths engenders an imperialist ethic whereby the beliefs must be spread into other populations. Second, the enactment of this spread through dementia awareness is considered, whereby people are presented as having wrong beliefs to justify the promotion of alternative correct knowledge. Third, some emerging contradictions within neuropsychiatric dementia are outlined, as moves toward early diagnosis and “living well” sit uneasily beside notions of dementia as a frightening epidemic. The paper concludes that this produces dissonant dementia wherein contradictory meanings are held together. Finally, it is suggested that this dissonance will likely continue, underpinned by specific interests.