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Death Not Necessarily Painful
Losing a loved one is always painful,
but the knowledge that the person didn't suffer in the end can
be some small comfort to family and friends.
So, the findings of a new study
may offer solace to the bereaved.
In the September issue of Neuropsychopharmacology,
researchers from the Netherlands report that levels of the stress
hormone cortisol rise just before death as a result of the failure
of bodily functions, not because of fear or pain.
"The levels of cortisol, our
stress hormone, are strongly rising in the blood and cerebrospinal
fluid in the last phase of our life," says study author Dr.
Dick Swaab, director of Neurobiology at the Netherlands Institute
for Brain Research in Amsterdam.
Cortisol, Swaab explains, protects
the body and the brain in stressful circumstances and it helps
to make energy available for the body to react to danger or stress.
Swaab says the question researchers
wanted to answer was why these levels rise. They particularly
wanted to know if psychological fear or physical suffering were
responsible for the jump in cortisol levels.
To answer this question, Swaab
and his colleagues compared cortisol levels from 85 Alzheimer's
patients to levels in 52 other people without dementia after their
death. The researchers also looked at cortisol levels in 19 control
patients and 54 Alzheimer's patients who were given high-dose
painkilling treatment with morphine during the last two weeks
of their lives.
"In individuals who are not
conscious of the fact that they are going to die because they
are demented or because they are exposed to high doses of morphine,
the same strong rise in cortisol levels was found," explains
Swaab.
In fact, cortisol levels were consistently
higher in the people with Alzheimer's. In the control group, those
treated with morphine had slightly lower levels of cortisol, but
the Alzheimer's patients who were given morphine had higher levels
of cortisol than those who didn't receive morphine.
That means, he says, that the psychological
stress or the fear of dying isn't the cause of the cortisol rise
because the Alzheimer's patients didn't know they were going to
die. It also means that physical pain isn't the cause of the cortisol
rise either, because patients on high doses of morphine still
had high increases in their levels of cortisol.
Swaab says the higher levels of
cortisol may simply be a protective physiological response that
occurs as different body functions start to fail.
"This study shows that patients
don't necessarily recognize the stress of dying. It's more physiological
than psychological," says Dr. Annette Carron, director of
palliative care services at William Beaumont Hospital in Royal
Oak, Mich. "It's nice for families to think that they're
not suffering."
More information
This article from the Medical College
of Wisconsin discusses the benefits of end
of life care. To learn more about Alzheimer's disease, go
to the Alzheimer's
Disease Education and Referral Center.
Reference
Source 101
For more information on how to prevent other diseases, use
PreventDisease.com's "Quick
Prevention Resources".
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