Vision and Dementia
Why Vision Matters in Dementia Care
An essential guide for care professionals on the critical, often overlooked link between vision and dementia.
A Two-Way Street: Vision & Cognition
Vision and cognition are deeply intertwined. Problems with one can directly mimic or cause problems with the other, creating a cycle that can be challenging for residents and care teams alike.
Vision Problems
Can mimic, predict, and worsen cognitive decline. A resident struggling to see may appear confused or disoriented, symptoms easily mistaken for dementia progression.
Cognitive Decline
Dementia can impair vision even with healthy eyes. The brain may struggle to process signals, affecting depth perception, contrast sensitivity, and facial recognition.
Vision: A Modifiable Risk Factor
One of the most powerful findings in recent research is that vision loss is not just a symptom, but a modifiable risk factor for dementia. Taking action on vision is a tangible way to protect cognitive health.
Untreated Vision Loss Leads To
50%
Increased Risk of Dementia
Vision Changes Can Predict Dementia Up To
12
Years in Advance
The Power of Correction
The good news is profound: correcting vision problems with glasses or surgery can remove this increased risk entirely. It's one of the most effective preventative strategies available.
Common Visual Challenges in Dementia
Different types of dementia affect vision in unique ways. Recognizing these specific patterns is key to providing tailored support and care.
Impact Within the Care Environment
For residents in care homes, visual impairments create a web of interconnected challenges that affect safety, well-being, and social engagement.
This chart illustrates the high impact of visual impairment across critical areas of a resident's life, with fall risk and misinterpretation of behavior being major concerns for care teams to address.
Your Role: Observation is Key
As care professionals, you are uniquely positioned to spot the subtle signs of vision problems. Your keen observations are the first step toward intervention.
👀 Physical Signs
- Squinting or rubbing eyes
- Tilting head to see better
- Watery or red eyes
- Complaints of headaches
🚶♂️ Navigational Issues
- Bumping into furniture/walls
- Hesitation at steps or curbs
- Difficulty locating items
- Shuffling or uncertain gait
🍽️ Task-Related Difficulties
- Struggling to eat or pour drinks
- Trouble with dressing/buttons
- Difficulty recognizing faces
- Misplacing items in plain sight
😊 Behavioral Changes
- Avoiding favorite activities
- Increased anxiety or agitation
- Withdrawal from social events
- New or increased hallucinations
🗣️ Communication Tips
- Approach from the front and within central visual field.
- Use clear, simple language.
- Give verbal cues to support visual information.
- Reduce background noise and distractions.
- Be patient and allow extra time for processing.
🤝 Collaborate
- Communicate observations promptly to GP and optician.
- Provide detailed information on behavioral changes.
- Work together to ensure a holistic care plan.
- Utilise domiciliary opticians for expert assessment and support.
Create a Vision-Friendly Environment
Simple environmental adaptations can make a world of difference, enhancing safety, reducing confusion, and improving quality of life for all residents.
Improve Lighting
Ensure good, even, non-glaring light. Avoid sudden changes between bright and dark areas.
Increase Contrast
Use contrasting colours for plates/tables, toilet seats/suites, and handrails/walls.
Reduce Clutter
Keep pathways and personal spaces clear to reduce visual confusion and fall risks.
Use Clear Signage
Employ large, clear, high-contrast signs for rooms and bathrooms against plain backgrounds.
Key References & Further Reading
Supporting the evidence-based insights presented in this infographic.
- Livingston, G., et al. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. *The Lancet*, 396(10248), 413-446.
- Swenor, B. K., et al. (2019). The Impact of Vision Impairment on Cognitive Decline and Dementia: A Systematic Review. *Journal of Alzheimer's Disease*, 67(4), 1279-1294.
- Brennan, M., & Watson, S. (2019). Vision and dementia: A review of the literature. *Dementia*, 18(3), 1019-1033.
- Royal National Institute of Blind People (RNIB). (Ongoing resources). Information on vision loss and dementia.
- Alzheimer's Society. (Ongoing resources). Information and support for living with dementia, including visual challenges.
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Simulation of Visual Impairments in Dementia
Alzheimer’s Disease
– Difficulty with depth perception and spatial relationships
– Problems distinguishing between similar colours, especially blues and greens
– Reduced contrast sensitivity – difficulty seeing objects against similar backgrounds
– Visual agnosia – inability to recognise familiar objects despite clear vision
– Difficulty with visual attention and scanning
– Problems with visual memory and recognition
Below is an interactive visualisation of what this may present as:
Vascular Dementia
– Visual field defects – blind spots or reduced peripheral vision
– Misperceptions and hallucinations
– Difficulty with visual-spatial tasks
– Processing speed delays in visual information
Below is an interactive visualisation of what this may present as:
