Visual Clues That Tell If Someone Has Dementia

There are several strong visual clues that can indicate that someone may have dementia, such as Alzheimer's disease. Keep in mind, however, that these indicators can also be caused by other conditions, and they can vary greatly by what's normal for the individual.

Confused Facial Expression on a woman
triffitt/ Getty Images

Personal Hygiene

As routines are disrupted by memory difficulties, a lack of personal hygiene is often one of the first indications that someone is having major problems. Previously clean and tidy individuals may begin to look unkempt. Problems with poor toileting habits, bathing, and incontinence cause staining and odors. Appearance, previously important, gradually loses meaning.


When someone with dementia dresses without assistance, they can struggle with putting clothes on in the wrong order, choosing clothes that go well together, and wearing clothes that are not appropriate for the weather. Some people will attempt to wear the same clothing every day because they've forgotten that they wore it the last three days in a row. Persons with dementia may also not notice stains or odors on clothing.

Gait and Motor Activity

Different types of dementia can affect gait and posture, and as dementia progresses into the later stages, the majority of the person's functioning declines. You may observe this as hesitant steps, difficulty with visuospatial tasks such as going up and down stairs, or challenges with balance. You may also see decreased physical movement due to apathy, or increased movement such as frequent wandering and restlessness.

Facial Expression

Facial expression in people with dementia may be affected, even in the earlier stages. The person's facial expression may be inappropriate to the situation at times, such as laughing in a serious or sad time or sudden tearfulness when there doesn't seem to be any trigger. People with dementia may also reflect feelings of anxiety, depression, agitation, bewilderment or a lack of feelings.

What to Do If You're Concerned

Remember that these visual signs are only one aspect of the person, and they may be related to other conditions. Additionally, some people with dementia initially demonstrate very few of these visual clues, causing much surprise when they're diagnosed with dementia because "they look so healthy."

If you're worried that someone has dementia, review these 10 warning signs of dementia and make an appointment with the physician for an evaluation. While this may be an anxiety-provoking step to take, a doctor's assessment can also help by identifying reversible causes of confusion or by identifying dementia and beginning treatment as early as possible.

4 Sources
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  1. Alzheimer's Association. Dressing and grooming.

  2. Amboni M, Barone P, Hausdorff JM. Cognitive contributions to gait and falls: evidence and implications. Mov Disord. 2013;28(11):1520-33. doi:10.1002/mds.25674

  3. UCLA Health. Depression and apathy.

  4. Park S, Kim T, Shin SA, et al. Corrigendum: Behavioral and neuroimaging evidence for facial emotion recognition in elderly Korean adults with mild cognitive impairment, Alzheimer's Disease, and frontotemporal dementia. Front Aging Neurosci. 2019;11:91. doi:10.3389/fnagi.2017.00389

By Christine Kennard
 Christine Kennard is a psychiatric nurse practicing in the United Kingdom and co-author of "Alzheimer's Disease: An A-Z For New Caregivers."