He is currently the executive director of the Brain Preservation Foundation and the author of The Future Loves You: How and Why We Should Abolish Death (2025). An 81-year-old woman with advanced Alzheimer’s is living in a retirement home in Iceland. She hasn’t recognised her family or spoken a word to them in a year.
One day, while her son Lydur is sitting beside her working on a crossword puzzle, she sits up and looks him directly in the face. This case, reported in a 2011 study by the biologist Michael Nahm and colleagues from the University of Virginia and the University of Iceland, is an example of terminal lucidity: an unexpected return of cognitive function in patients with severe dementia (or other brain damage) that occurs shortly before death. As a neuroscientist, my first thoughts when encountering reports like this are that they can’t possibly be real.
The main reason is that, by the time patients with severe dementia die, their brains are catastrophically damaged. For a protracted period before death, these patients typically show no signs of recognising family members. They often haven’t responded meaningfully to their environment in months or years.
And they’ve lost 20 to 50 per cent of their synaptic connections – so much that their brains have visibly shrunk on MRI scans. On top of this existing damage, the dying process itself is hardly optimal for brain function. Everything we know about neuroscience says this should make cognition worse, not better.
And yet, terminal lucidity keeps being reported. If a dying brain can spontaneously access ‘lost’ memories, perhaps we could induce a living brain to do the same In some reports, 60 to 70 per cent of dementia caregivers say they’ve witnessed at least one patient return to lucidity in the days before death. In a study that specifically followed deaths in hospice, researchers found examples of terminal lucidity in 6 per cent of cases.
That makes the phenomenon neither ubiquitous nor rare – in the US alone, it would mean around 10,000 cases per year. This potentially has profound implications for neuroscience and medicine. Retaining memories depends on neural circuitry maintaining specific synaptic connection strengths.
Extract — continue reading at the source.
