Dementia is often described as “the long goodbye”. Although the person is still alive, dementia slowly and irreversibly chips away at their memories and the qualities that make someone “them”.

Dementia eventually takes away the person’s ability to communicate, eat and drink on their own, understand where they are, and recognise family members.

Since as early as the 19th century, stories from loved ones, caregivers and health-care workers have described some people with dementia suddenly becoming lucid. They have described the person engaging in meaningful conversation, sharing memories that were assumed to have been lost, making jokes, and even requesting meals.

It is estimated 43% of people who experience this brief lucidity die within 24 hours, and 84% within a week.

Why does this happen?

Terminal lucidity or paradoxical lucidity?

In 2009, researchers Michael Nahm and Bruce Greyson coined the term “terminal lucidity”, since these lucid episodes often occurred shortly before death.

But not all lucid episodes indicate death is imminent. One study found many people with advanced dementia will show brief glimmers of their old selves more than six months before death.

Lucidity has also been reported in other conditions that affect the brain or thinking skills, such as meningitis, schizophrenia, and in people with brain tumours or who have sustained a brain injury.

Moments of lucidity that do not necessarily indicate death are sometimes called paradoxical lucidity. It is considered paradoxical as it defies the expected course of neurodegenerative diseases such as dementia.

But it’s important to note these episodes of lucidity are temporary and sadly do not represent a reversal of neurodegenerative disease.

Why does terminal lucidity happen?

Scientists have struggled to explain why terminal lucidity happens. Some episodes of lucidity have been reported to occur in the presence of loved ones. Others have reported that music can sometimes improve lucidity. But many episodes of lucidity do not have a distinct trigger.

A research team from New York University speculated that changes in brain activity before death may cause terminal lucidity. But this doesn’t fully explain why people suddenly recover abilities that were assumed to be lost.

Paradoxical and terminal lucidity are also very difficult to study. Not everyone with advanced dementia will experience episodes of lucidity before death. Lucid episodes are also unpredictable and typically occur without a particular trigger.

And as terminal lucidity can be a joyous time for those who witness the episode, it would be unethical for scientists to use that time to conduct their research. At the time of death, it’s also difficult for scientists to interview caregivers about any lucid moments that may have occurred.

Explanations for terminal lucidity extend beyond science. These moments of mental clarity may be a way for the dying person to say final goodbyes, gain closure before death, and reconnect with family and friends. Some believe episodes of terminal lucidity are representative of the person connecting with an afterlife.

Why is it important to know about terminal lucidity?

People can have a variety of reactions to seeing terminal lucidity in a person with advanced dementia. While some will experience it as being peaceful and bittersweet, others may find it deeply confusing and upsetting. There may also be an urge to modify care plans and request lifesaving measures for the dying person.

Being aware of terminal lucidity can help loved ones understand it is part of the dying process, acknowledge the person with dementia will not recover, and allow them to make the most of the time they have with the lucid person.

For those who witness it, terminal lucidity can be a final, precious opportunity to reconnect with the person that existed before dementia took hold and the “long goodbye” began.

Yen Ying Lim, Associate Professor, Turner Institute for Brain and Mental Health, Monash University and Diny Thomson, PhD (Clinical Neuropsychology) Candidate and Provisional Psychologist, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

At this time of year many of us resolve to prioritise our health. So it is no surprise there’s a roaring trade of products purporting to guarantee you live longer, be healthier and look more youthful.

While an estimated 25% of longevity is determined by our genes, the rest is determined by what we do, day to day.

There are no quick fixes or short cuts to living longer and healthier lives, but the science is clear on the key principles. Here are five things you can do to extend your lifespan and improve your health.

1. Eat a predominantly plant-based diet

What you eat has a huge impact on your health. The evidence overwhelmingly shows eating a diet high in plant-based foods is associated with health and longevity.

If you eat more plant-based foods and less meat, processed foods, sugar and salt, you reduce your risk of a range of illnesses that shorten our lives, including heart disease and cancer.

Plant-based foods are rich in nutrients, phytochemicals, antioxidants and fibre. They’re also anti-inflammatory. All of this protects against damage to our cells as we age, which helps prevent disease.

No particular diet is right for everyone but one of the most studied and healthiest is the Mediterranean diet. It’s based on the eating patterns of people who live in countries around the Mediterranean Sea and emphases vegetables, fruits, wholegrains, legumes, nuts and seeds, fish and seafood, and olive oil.

2. Aim for a healthy weight

Another important way you can be healthier is to try and achieve a healthy weight, as obesity increases the risk of a number of health problems that shorten our lives.

Obesity puts strain on all of our body systems and has a whole myriad of physiological effects including causing inflammation and hormonal disturbances. These increase your chances of a number of diseases, including heart disease, stroke, high blood pressure, diabetes and a number of cancers.

In addition to affecting us physically, obesity is also associated with poorer psychological health. It’s linked to depression, low self-esteem and stress.

One of the biggest challenges we face in the developed world is that we live in an environment that promotes obesity. The ubiquitous marketing and the easy availability of high-calorie foods our bodies are hard-wired to crave mean it’s easy to consume too many calories.

3. Exercise regularly

We all know that exercise is good for us – the most common resolution we make this time of year is to do more exercise and to get fitter. Regular exercise protects against chronic illness, lowers your stress and improves your mental health.

While one of the ways exercising helps you is by supporting you to control your weight and lowering your body fat levels, the effects are broader and include improving your glucose (blood sugar) use, lowering your blood pressure, reducing inflammation and improving blood flow and heart function.

While it’s easy to get caught up in all of the hype about different exercise strategies, the evidence suggests that any way you can include physical activity in your day has health benefits. You don’t have to run marathons or go to the gym for hours every day. Build movement into your day in any way that you can and do things that you enjoy.

4. Don’t smoke

If you want to be healthier and live longer then don’t smoke or vape.

Smoking cigarettes affects almost every organ in the body and is associated with both a shorter and lower quality of life. There is no safe level of smoking – every cigarette increases your chances of developing a range of cancers, heart disease and diabetes.

Even if you have been smoking for years, by giving up smoking at any age you can experience health benefits almost immediately, and you can reverse many of the harmful effects of smoking.

If you’re thinking of switching to vapes as a healthy long term option, think again. The long term health effects of vaping are not fully understood and they come with their own health risks.

5. Prioritise social connection

When we talk about living healthier and longer, we tend to focus on what we do to our physical bodies. But one of the most important discoveries over the past decade has been the recognition of the importance of spiritual and psychological health.

People who are lonely and socially isolated have a much higher risk of dying early and are more likely to suffer from heart disease, stroke, dementia as well as anxiety and depression.

Although we don’t fully understand the mechanisms, it’s likely due to both behavioural and biological factors. While people who are more socially connected are more likely to engage in healthy behaviours, there also seems to be a more direct physiological effect of loneliness on the body.

So if you want to be healthier and live longer, build and maintain your connections to others.

Hassan Vally, Associate Professor, Epidemiology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.