title: The pursuit of certainty in diagnosing dementia: cognitive testing, childishness and stress in two British memory clinics.
abstract: By often taking as its focus the experience of illness in itself, medical anthropology has sometimes neglected the meanings that patients may assign to the diagnostic procedures that they are expected to undergo. This paper puts into anthropological perspective the author's experiences working as an assistant psychologist in two British memory clinics for the detection and treatment of dementia, using comments by patients to illustrate the significance that one aspect of these procedures--cognitive testing--had for them. These comments suggest that the meanings that patients construct with regard to such testing are complex and cannot be understood if one persists in seeing it as a neutral diagnostic tool without broader implications. It is argued that a strong association made by many patients between the cognitive tests and their childhood school experiences informs their reactions for better or worse. It is important to acknowledge the implications of this active interpretation of medical procedures if the memory clinic experience is not to become an alienating and infantilising one.
authors.affiliation: Department of Anthropology, University College London, London WC1H 0BW, UK. d.orr@ucl.ac.uk
authors.forename: David M R
authors.initials: DM
authors.lastname: Orr
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities; D000883:Anthropology; D003704:Dementia / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D013315:Stress, Psychological / Q000523:psychology*; D058013:Test Taking Skills / Q000523:psychology*; D006113:United Kingdom