Should We Research Dementia Patients’ Lucidity, Too?

When we think of dementia, symptoms like memory loss and confusion might spring to mind. And that’s completely reasonable – dementia is a condition that progressively affects memory and thinking.

But researchers think there are other parts to the picture.

People with dementia can have periods of “paradoxical lucidity”, or moments when a long-term dementia patient’s brain seems to briefly snap back to what it once was. Carers say moments like these are common.

They can last for minutes or hours and may make a dementia patient’s loved one feel as if, for a while at least, the “fog lifted”.

Dr Heather E. Whitson, a professor of neuroscience, the director of the Duke Ageing Centre, and co-director of the Duke/UNC Alzheimer’s Disease Research Centre, said: “I really think that a lot of what we learn about these dramatic episodes could have bearing on better cognition and better outcomes throughout the disease.”

She is one of many academics who’ll join the Lucidity in Alzheimer’s and Dementia (LEAD) Network.

The upcoming project, due to start this autumn, aims to create a standard definition of lucidity, understand how it affects caregivers and families, and work out the mechanisms behind lucid periods.

Some reports suggest that triggers like music may help to induce these states of clarity among dementia patients. But the team behind LEAD Network want more hard science to explain what’s really going on during clearer spells.

It’s even hoped that working out why lucidity happens in dementia could help researchers find ways to protect us from the condition, and even recover memories.

“We’ve spent decades focused on preventing dementia and treating dementia,” Whitson stated. “This research asks a different question: What allows moments of preserved function to emerge, even in the setting of advanced disease?”

Lucidity among long-term dementia patients may have to do with what’s been called the brain’s “substrate”, or the hidden, underlying part of the brain that still seems capable of regular, or better-than-usual, function.

Dr Whitson said that the times when a person with advanced dementia is able to remember a loved one or sing every chorus of a song “suggest there is still some preserved substrate there. It means that a profound part of their self – which dementia took away – is still there”.

Maybe research like the one she and others are set to undertake could make accessing that “substrate” more predictable and reliably possible.

The professor claimed, “Neuroscientists often frame cognitive resilience as your mind’s ability to hang on to a capacity even though there is brain damage.

“But lucid episodes tell us that even when a capacity seems as if it’s lost, it may not be lost forever.”