Unexpected cognitive lucidity and communication in patients with severe dementias, especially around the time of death, have been observed and reported anecdotally. Here, we review what is known about this phenomenon, related phenomena that provide insight into potential mechanisms, ethical implications, and methodologic considerations for systematic investigation. We conclude that paradoxical lucidity, if systematically confirmed, challenges current assumptions and highlights the possibility of network-level return of cognitive function in cases of severe dementias, which can provide insight into both underlying neurobiology and future therapeutic possibilities.
Bibliographical noteFunding Information:
The authors thank Basil A. Eldadah, MD, PhD, as well as his team members from the National Institute on Aging for catalyzing and supporting discussions related to lucidity in dementia.
© 2019 The Authors
- Alzheimer's disease
- End-of-life care