The Fleeting Moments of Clarity in Dementia Patients

Were those capabilities ever gone?

An illustration of a person's brain with clouds around it

This is a summary of a story by Liz Switzer on Duke School of Medicine.

One of the great mysteries of Alzheimer’s Disease and dementia is the rare lucid moment. People with advanced dementia who haven’t spoken in weeks or months suddenly become clear-eyed and communicative, if for just a brief period.

It is an emotional and vexing moment that science still struggles to explain. Lucid episodes or paradoxical lucidity — described as brief, unexpected periods of heightened awareness, communication, or cognitive function in people — can last minutes or hours before disappearing as suddenly as they begin. Caregivers have described these moments for decades, but scientists still know little about them.

At Duke, Heather Whitson wants to figure it out. A neuroscientist and director of the Duke Aging Center, Whitson is teaming with researchers at the University of Wisconsin and the Mayo Clinic to lead an NIH-funded study attempting to untangle this puzzle.

The project, called Lucidity in Alzheimer’s and Dementia Network, or LEAD, is the nation’s first consortium dedicated to studying that specific topic. The consortium’s work centers on three goals: developing a standard definition of lucidity, understanding its impact on caregivers and families, and uncovering the neural mechanisms that make these episodes possible.

“We want to understand what is happening at the level of brain circuits, cells, and molecules,” said Whitson, who also co-directs the Duke/UNC Alzheimer’s Disease Research Center.

The project includes experts such as Whitson in neuroscience as well as psychology, geriatrics, caregiving, data science and measurement science.

Much of the strategy hinges on turning a key question around. Instead of focusing on why the brain fails, these researchers hope to learn why, occasionally, a failed brain appears to briefly recover.

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

Read the full story on Duke School of Medicine.