What is Dementia?
Dementia describes a variety of conditions related to mental impairment. It includes memory loss, inability to think clearly and reason, and decision-making.
Alzheimer’s is the most well-known form of dementia but is by no means the only disease under this umbrella.
In most cases, dementia interferes with someone’s ability to function day-to-day. It tends to affect older adults. But younger people are not immune to developing dementia. Despite its prevalence in the older community, it is not a normal part of aging.
Dementia is more than just slight memory lapses and often involves emotional and physical changes, as well. This is especially true in its advanced stages.
People with Alzheimer’s disease and dementia struggle with a variety of secondary health issues, including vision problems.
Both dementia and vision loss are disorienting. When the two occur simultaneously, daily life becomes an emotional and physical challenge.
How Does Dementia Affect Eye Health?
Declining vision is common among older adults. As we age, our vision tends to be less sharp than it once was. This is true even for people who have no serious vision health concerns.
Low vision, which may result from macular degeneration, doesn’t mean you'll go blind. However, low vision and dementia combined make even simple tasks difficult.
It is especially challenging for someone with dementia to experience normal vision decline or more serious issues. Routine activities and communication can become extremely difficult.
A person’s environment becomes frustrating and their daily life a nightmare when their brain is unable to process what they see. Low vision challenges are also stressful for the loved ones of someone with dementia.
The combination of dementia and vision loss leads to:
- Increased risk of falls and other accidents
- Difficulty transitioning from light to dark spaces
- Greater need for assistance
- Difficulty learning new technology and/or equipment
- Misidentification of people
- Misperceptions of activities
Both dementia and low vision create challenges for patients and their loved ones. This includes an increased risk of accidents and injuries.
Being proactive about creating a safe, comfortable environment prevents many common issues that arise in dementia patients with low vision.
What Causes Dementia-Induced Vision Loss?
There are many causes of vision impairment and vision loss. This is especially true as you age or experience macular degeneration.
However, people with dementia have a heightened risk of vision loss.
In some cases, these are vision issues anyone can experience (such as impaired vision from cataracts), but the person with dementia is unable to communicate vision changes. The problem is advanced before other people recognize an issue.
There are also changes in vision that are related to dementia but not directly to eye health.
Dementia affects the part of the brain responsible for managing visual input. Their eyes are otherwise healthy, but the message sent from the eye is misinterpreted by the unhealthy brain.
The two most common problems dementia patients have with vision include:
- Misperception: They see one thing but their brain interprets it as something else.
- Misidentification: They see something or someone but the brain is unable to identify it properly.
Different types of dementia affect eye health and sight loss in different ways. People with dementia might experience:
- Inability to recognize color differences
- Inability to describe what they see
- Inability to detect movement
- Mistake TV images for real life
- Grow restless or agitated due to a visual overstimulation from bright lights, busy patterns, and more
Being able to see involves several stages, beginning with the eye. What the eye sees must be properly interpreted by the brain. Memories, thoughts, and other senses also play a role.
Someone with perfect eye health could experience problems if their brain misinterprets information. If a person’s brain is affected by dementia, it affects exactly what they think they see. The problem worsens when there are problems with visual impairment and health.
Impact of Vision Loss & Dementia
Vision loss exacerbates many common symptoms of dementia.
For example, common dementia symptoms of dementia like disorientation are worse when someone has low vision. This is true whether there are problems with their eyes or if dementia is causing their visual problems.
Profound disorientation can cause a person significant emotional distress and lead to injury to themselves and others.
Everyday tasks become challenging and might be the starting point of emotional or behavioral issues for someone with Alzheimer’s, Parkinson’s disease, dementia, and other issues.
When someone with dementia experiences vision loss, they are at greater risk of:
- Miscommunicating or misinterpreting things other people say
- Social isolation
- Resisting tools and adaptive techniques to help with their visual issues
- Neglecting their hygiene
- Giving up activities they once enjoyed, such as reading or playing games
- Agitation or sensory overload
- Neglecting physical fitness
A person with dementia experiences massive disruptions in their life.
Most dementia-related diseases change every aspect of someone’s day-to-day existence. Visual impairment compounds these problems and makes it more difficult to treat and manage both issues.
How to Support People With Vision Loss & Dementia
Many things can be done to support people with low vision and vision impairment who also struggle with dementia. For example:
6 Tips for Patients
1. Focus on your current-day abilities
Despite changes occurring, it’s important to enjoy things as much as possible with your remaining vision. Maybe you can no longer drive, but you’re still able to read or watch television. If these activities are no longer possible, you can listen to music or audiobooks.
2. Make healthy eyes and overall vision health a priority as soon as you’re diagnosed with dementia
A sight test can help you assess your current vision status.
3. Don’t be embarrassed to share your concerns with loved ones and/or your doctor
If you notice vision changes or something doesn’t seem right, tell someone.
4. Ask for help when you need it
Trying to do too much can put you at risk. It’s always better to seek assistance than to try to do too much.
5. Ask loved ones to adapt in ways that will make things easier on everyone
For example, it might help to have family members identify themselves before they begin speaking to you.
6. Speak to your doctor about macular degeneration and various health conditions that cause low vision
Early detection of issues also helps you put an effective treatment plan in place.
6 Tips for Parents and Caretakers
1. Keep your loved one’s physical environment as consistent as possible
However, some changes are needed to improve safety. When this is necessary, carefully explain the changes to your loved one and help them navigate their altered surroundings.
2. Research technology that makes your loved one’s life easier
This includes audiobooks, audio or large print labels, magnifiers, and motion-activated lighting. Don’t be surprised if your loved one isn’t receptive to technological support. Be patient and make it available without forcing them to use these tools. Introducing these tools in the early stages of vision loss avoids the frustration that occurs once someone is struggling to see.
3. Make changes gradually
It’s tough for anyone to adapt to new things, but it’s especially challenging for dementia patients.
4. Reach out to support organizations for help
There might be tools, information, and other resources that will make your life and your loved one’s life easier. The Alzheimer’s Society and similar groups provide information and low vision services that families can use that make things easier.
5. Research vision rehabilitation services in your area
That provide support with vision impairment for older adults and their families.
6. Understand that visual hallucinations are a part of dementia for some people
Knowing this and having a better understanding how to react is important and can avoid a lot of fear and stress.
3 Tips for Optometrists
1. Look for resources to help you support dementia patients
Especially if you haven’t worked with the special needs community before.
2. Speak with loved ones about the patient’s vision health
In some cases, you’ll need to obtain permission from the patient to discuss their health with family members. Encourage them to be proactive and keep up with routine vision exams.
3. Schedule extra time for appointments with dementia patients
If possible, consider home visits.
Dementia Resource Links
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