You can't diagnose dementia solely by looking at someone's eyes, but changes in how they look (vacant stare, glazed-over) and how they use their vision (difficulty focusing, depth perception issues, gaze avoidance) can be signs because dementia disrupts the brain's ability to process visual information. While these behavioral signs are noticeable, specialized eye exams can detect subtle physical changes in the retina's blood vessels and nerve fibers that correlate with early Alzheimer's, and pupil response during memory tasks may also show promise as biomarkers.
Alzheimer's disease causes the person to develop a mask-like facial expression. This minimizes typical facial expressions of pain, like a drawn mouth or furrowed brows. Also, patients may have lost the cognitive ability to tell caregivers about their pain with phrases such as "this hurts" or "I am in pain."
However, new research suggests that the eyes may provide an early warning system for detecting Alzheimer's long before symptoms appear. Scientists have discovered that proteins linked to the disease, such as amyloid, can be detected in the eyes, opening the door for potential early diagnosis through retinal exams.
Early-Onset Dementia Symptoms
Dementia behaviors stem from brain changes and include personality shifts, memory issues, mood swings (anxiety, depression, irritability), agitation, aggression, delusions, hallucinations, disinhibition (saying/doing inappropriate things), repetitive actions (pacing, fiddling), and sleep disturbances (sundowning). These symptoms are the disease, not the person, and often result from unmet needs, communication breakdowns, environmental triggers, or underlying pain, requiring patient redirection, routine, and focusing on comfort.
The "2-finger test" for dementia involves an examiner showing a hand gesture (like interlocking index and middle fingers) and asking the patient to copy it, testing motor skills, visual memory, and coordination, as difficulties can signal early cognitive decline, but it's a screening tool, not a definitive diagnosis, prompting further medical evaluation. Other related tests include finger-tapping and finger-to-nose, looking for hesitation or misjudgment in movement.
A recent meta-analysis revealed that higher neuroticism and lower conscientiousness are consistent predictors of higher dementia risk, across dementia types, including Alzheimer's disease (AD), dementia assessment methods, follow-up lengths, and countries (Aschwanden et al., 2021).
The 5-word memory test is a cognitive screening tool. This approach is simple—a person is told 5 words in a specific order, and a few minutes later, they're asked to recall them in the same order. It's often used by healthcare providers to test memory and short-term recall.
Although the early signs vary, common early symptoms of dementia include: memory problems, particularly remembering recent events. increasing confusion.
2. Wandering. Six out of 10 people living with dementia wander at least once, according to the Alzheimer's Association. For some, the urge to wander often occurs later in the day because of sundowning.
Changes in the eyes are often overlooked but can be a significant indicator of underlying neurological conditions like dementia and Alzheimer's. These changes, though subtle, can manifest in various ways, from pupil size and reactivity to overall gaze and eye movement patterns.
The 10 warning signs of dementia include memory loss, difficulty with familiar tasks, confusion about time/place, trouble with language, poor judgment, misplacing things, personality changes, loss of initiative, and problems with visual/spatial skills, requiring professional assessment to distinguish from normal aging.
You Miss Out on Sleep
You do a few things you know you shouldn't -- we all do. But some of those bad habits can take a toll on your brain. For example, lack of sleep may be a cause of dementia, including Alzheimer's disease. It's best to have regular sleeping hours.
The 90-second rule states that people with dementia may take up to 90 seconds to process information. For example, if you ask Mr. Smith “can you stand up from the chair?” he may take up to 90 seconds to process the command and stand up.
Common early symptoms of dementia
Our results confirm that vitamin D deficiency is associated with a substantially increased risk of all-cause dementia and Alzheimer disease.
Even though a person with dementia may end up sleeping more than a typical person of their age – even as much as 14–15 hours a day – it is unlikely to all be good quality sleep. Sleeping a lot can also be influenced by people's sleeping patterns before they had dementia, as some people need more sleep than others.
For most people with Alzheimer's — those who have the late-onset variety — symptoms first appear in their mid-60s or later. When the disease develops before age 65, it's considered early-onset Alzheimer's, which can begin as early as a person's 30s, although this is rare.
The SAGE test is a short, self-administered evaluation that screens for early signs of memory or thinking problems like dementia. You take it on your own, at home or at your provider's office. It's simple and there's no studying needed. It can catch issues early.
Vitamin D supplements are linked to a significant reduction in dementia risk, with a major study showing users had a 40% lower incidence of developing dementia compared to non-users, particularly benefiting older adults, with even greater effects seen in women and those without existing cognitive issues. This reduction highlights Vitamin D's role in brain health, possibly by clearing amyloid plaques associated with Alzheimer's.
The number one cause of dementia is Alzheimer's disease, responsible for 60-80% of cases, characterized by brain plaques (beta-amyloid protein) and tangles (tau protein) that damage nerve cells, leading to progressive memory and cognitive decline, though vascular dementia from blood vessel damage is also a significant factor.
Age. The biggest risk factor for dementia is ageing. This means as a person gets older, their risk of developing dementia increases a lot. For people aged between 65 and 69, around 2 in every 100 people have dementia.
There is currently no cure for dementia, but recognising the early signs and symptoms is still very important. We explore why spotting the early signs matters for everyone affected by dementia and why we support research to improve diagnosis.
You can live with dementia for an average of 4 to 10 years after diagnosis, but this varies significantly, with some people living 20 years or more, depending on age, overall health, and dementia type, with Alzheimer's averaging 8-10 years and vascular dementia closer to 5 years. Factors like diagnosis stage, age, gender, other health conditions (e.g., heart disease, frailty), and dementia subtype greatly influence life expectancy, with people often succumbing to infections or complications rather than the disease itself.