[allig256]

Alzheimer's is the least likely to kill you of "The Four Horsemen", however it seems to be the most elusive in terms of prevention and treatment.

If deep sleep can contribute to prevention, it seems that yet again exercise is the going to be the best catch-all prophylactic.

[zarzavat]

It may be relatively less common but the slow death it inflicts is highly unpleasant, especially for the people around you. I strongly prefer to die of a heart attack.

[lambdasquirrel]

The worst part is that there isn't a well-defined point where you can say "I'd like to have a medically-assisted suicide" that isn't going to upset people (assuming it were legal). By the time you reach it, you quite possibly won't have the cognitive capacity to request it.

[petercooper]

My dad is a good example of this. He was very adamant he wanted to die if he became debilitated by dementia. Unfortunately he ended up having three strokes in quick succession while being diagnosed for vascular dementia and is now a totally different person (with zero recollection or connection to his previous personality or memories, as far as anyone medical can tell) living a pretty miserable life in a facility with 24/7 care, zero language abilities, etc. There was no singular moment he could have made the call. He was entirely cogent one day and absolutely not the next.

I would be very happy to sign off on his wishes, but there is no legal or medical route to do so, so whatever is left of him gets to suffer until his body gives up. I support them introducing some mechanism for this one day and would likely use it myself (all my ancestors went through dementia).

[raincole]

I don't believe there should be a "point" where you can say that. Medically-assisted suicide should be available for everyone. Of course with a prolonged evaluation period.

[thinkharderdev]

I took the parent to be saying something like "even if medically assisted suicide were available as an option without restriction, there is no point at which you would decide to do it because the onset of dementia is so gradual." That is, it would be difficult to make the decision (for some/most people at least) while you were still having lucid moments where you could still have some quality of life. And by the point where you have completely lost it, you are no longer of sound mind to consent to a medically assisted suicide.

[blagie]

I think one way to go is to do this early, with a clear bound. For example, one might set a rule that if they can:

* no longer compute ∫x²dx

* remember the capital of France; and

* recall where they were born

Then they have crossed that threshold.

Personally, though I don't want to be killed. At least by my values, killing is not okay. I think there are much better things to do, such as:

- Being frozen in Antarctica, in case medical technology improves in a century or two to the point where I can be revived and cured.

- Go some place where I will surely die, but where I can still do some good (running a school for girls in Afghanistan when the US was there is a good example)

- If none of that is possible, do something interesting and dangerous. For example, if my brain is going anyways, experimenting with drugs and dying by drug overdose seems like a decent way to go.

And to be abundantly clear, that's my opinion and my values. I'm not trying to decide for anyone else. I don't think these sorts of decisions should ever be forced, mandated, or imposed.

Footnote: Thresholds are hard to define. I did have one relative with complete loss of short-term memory who seemed to be having a wonderful life. They were happy, friendly, and told grand kids wonderful stories from decades past. It helped that they had a very easy-going personality. On the other hand, they didn't know how they got to where they were, or what we were talking about five minutes ago. They also didn't have any recent memories (e.g. if a relative had been married within the past half-decade or so, they wouldn't recognize the spouse). There was a point where I'm pretty sure they wouldn't have passed any reasonable threshold, but they seemed to be living a very full life surrounded by a big family who loved them. On the other hand, if my brain was where their brain was, I'm pretty sure I'd be completely miserable.

[grandfield]

> - Being frozen in Antarctica, in case medical technology improves in a century or two to the point where I can be revived and cured.

Given that cryonics is currently essentially just a scam, you might just as well. For all practical purposes, it's equivalent to killing. (Legally, you need to have just died though, in most Western countries, so I think you don't actually have this option.)

https://bigthink.com/the-future/cryonics-horror-stories/

Or you meant just traveling there, going on an extended hike from which you don't return because you just purposely one day didn't get out of your tent. That's not a pleasent way to die though, and nobody is going to go there 300 years from now to unthaw you.

> - If none of that is possible, do something interesting and dangerous. For example, if my brain is going anyways, experimenting with drugs and dying by drug overdose seems like a decent way to go.

How do you know that a drug overdose is a pleasant experience? You could be hallucinating the most terrible things in the world for as it may feel like an eternity. Unless you are talking about sleep medication, but then again, just taking a bunch of sleeping pills is not different from a "classical" suicide.

[jeromegv]

How is going to Afghanistan and manage a school something you should once once you reach advanced dementia? You’d think that it would make some good? To whom?

[mindvirus]

Flashbacks to high school

Teacher: "Compute ∫x²dx"

Me: "x^3/3"

Teacher: "You forgot the + C!"

RIP

[bigDinosaur]

Setting a rule is difficult because in n+1 years of dementia you've effectively started to become another person, and at some point you don't know if that person will honour the rule you made, or even be aware of how incapable of satisfying it they have become.

[candiddevmike]

If you're an organ donor, you'll do more good than any of those three options once you die, IMO.

[mensetmanusman]

Even with prolonged evaluation, there have been events where doctors are killing people who in the current state of mind changed their mind and resisted the entire time in front of their families.

I'm of the opinion humans will never be able to not abuse such a system. We easily see now the data on assisted deaths before tax holidays.

[prepend]

This sounds terrifying. Do you have any articles or accounts of this?

[mtlmtlmtlmtl]

I would do it myself the same day I was diagnosed.

[andy_ppp]

You’ll have days where you feel fine though and be having fun and enjoying life. It’s easy to say but the initial symptoms might be very mild.

[mtlmtlmtlmtl]

I've thought about it a lot. I want to die while I'm still enjoying life. So I can say goodbye to family and have them remember the person I was, not the shadow I became.

[VMG]

Let's hope you don't get the diagnosis in the afternoon then - the goodbyes might be a bit rushed otherwise

[hammyhavoc]

27 club y'say?

Guessing that ship has probably sailed.

[carlmr]

If you're not physically too old, maybe a good time to start a risky hobby like motorcycling, free solo rock climbing, base jumping.

[andy_ppp]

Strangely you become more risk averse and stuck in your little loops as you get older and the routines you have become fine, good even.

[stormfather]

This is an ideal use case for chatbots. Hook your carbon monoxide controller to an LLM trained to administer a reverse Turing test. I'm kidding, but not really. Our family is dealing with this and I am considering wiring this up for personal use down the road.

[hammyhavoc]

With how much LLMs hallucinate, I'd say this is a terrible use for chatbots.

[allig256]

Honestly a heart attack is how I hope I go, over in minutes!

[zelphirkalt]

... of agonizing pain.

Perhaps simply falling asleep at appropriate age and not waking up is to be preferred.

[lrem]

I suggest listening to Stuff You Should Know on this matter. Apparently dying in your sleep isn’t really a thing.

[tchaffee]

It can be with medical assistance.

[seunosewa]

Like a heart attack during your sleep? It might wake you up before it takes you out.

[lynx23]

It would also help if conservatives and believers would stop to work against the right to assisted death. It should be a human right to end ones life if so desired.

[dotancohen]

  > It should be a human right to end ones life if so desired.

Why? I have no opinion one way or the other, but what makes you feel that this particular action should be afforded the protections of the term "human right"?

[grandfield]

Assisted death is not the same as ending your life. It's asking somebody else to end your life.

In the land of the free, nobody is stopping you from ending your own life.

[kar5pt]

Yes they are. Materials used for safer, less painful suicide methods (such as helium) are made purposely hard to get. Plus the authorities will lock you in a psych ward if they find out about your intent.

[dotancohen]

How much helium is required for suicide? Would not a few dozen balloons be sufficient?

[mensetmanusman]

Forcing someone to provide things for you then?

[mensetmanusman]

Those pesky people that don't want to create a culture where you are expected to die if you feel you are a burden you mean?

[tombert]

Yeah, that's sort of the conclusion I've come to in the last ~6 years. There are so many likely-true benefits to exercise that it almost doesn't matter if a few of them turn out to be false, since no matter what you will probably still benefit from the net result.

[arthur2e5]

The "neurobiological effects of physical exercise" page on Wikipedia gets submitted on HN frequently with few votes, but man is it a fascinating read. Beyond the well-known runner's high, you get cognitive improvements in both short and long term. It even slows down Alzheimer's after you get it, allegedly.

Exercise is no panacea, but people really don't realize how many things it (allegedly) can do, even with super short durations you see in these interval training regimens. Don't force it on people with ME/CFS, sure, but most of us really can and should set aside an hour a week (or less, if you do SIT instead of HIIT).

[grandfield]

I don't have time for exercise.

I'm too busy bindging the next Netflix series. Anybody have good recommendations?

/s

[arthur2e5]

Well look, the sales pitch for SIT is that you get most of the HIIT goodness at three minutes per day of exercise. Now to hit the required intensity… how much is an indoor bike anyways?

[Earw0rm]

Good book on the topic: https://www.amazon.co.uk/Miracle-Pill-Ha-Peter-Walker/dp/147...

[hasbot]

Some exercises have the side benefit of being fun!

[tomp]

I’m not worried of dying of Alzheimers.

My grandma had dementia, she was “gone” way before she actually “died”.

[dmix]

> it seems that yet again exercise is the going to be the best catch-all prophylactic.

A novel idea

[mwbajor]

I know doctors that refer to alzheimers as type-3 diabetes. Their gut instinct long ago was that it was indirectly related to insulin regulation. I don't remember exactly how much more (its a large factor), but being overweight and/or having type 2 diabetes makes it much more likely to get alzheimers.