Can changes in someone’s face be an early sign of dementia?
Over the past few years, scientists have found that the brain affects the face, and that certain changes in our face may point to dementia. That doesn’t mean we can look at somebody’s face and say, yes, that’s dementia. But it does mean our faces hold signs.
Here’s what the research is actually showing, and what it does and doesn’t mean for your family.
Why Scientists Are Looking at the Face for Early Signs of Dementia
We’ve known for a long time that dementia affects way more than the memory problems most people think about. It affects motor control, how we move our bodies, the way we express emotions, the autonomic nervous system, inflammation, biological aging, and subtle changes in muscle movement and facial responsiveness.
Because dementia affects so much, scientists started asking themselves a question. Are there changes happening in the face that show up early, before the cognitive symptoms do?
And if so, could those facial changes help identify people at high risk? Or people showing very subtle early signs that aren’t affecting their day-to-day life yet?
The 2023 Study: Facial Micro-Movements in Dementia
In 2023, researchers compared adults with dementia and adults without it. They analyzed facial movements so small that the unaided eye wouldn’t even notice them.
Here’s what they found:
- People with dementia showed less variation in their facial expressions.
- Their facial micro-movements were subtly slower than those of people without dementia.
- The changes showed up especially in movement around the eyes and the mouth.
- Machine learning models were able to detect these changes at better than chance accuracy. They were picking up on something real, not something random.
It’s important to know how subtle these changes were. Family members would not be able to notice them in their loved ones. They are not visible to the naked eye.
The 2024 Facial Age Gap Study: Looking Older Than Your Age
In 2024, another study looked at facial changes and dementia risk in a different way. It compared how old somebody looks with how old they really are. You could call it the facial age gap.
People who looked significantly older than their actual age were at higher risk of developing dementia. Looking older is often linked to other things going on underneath, such as inflammation, poorer vascular health and overall biological aging.
Now, this doesn’t mean that looking older means someone has dementia, or that they’re going to get it. It does mean the face can reflect underlying health.
An older-looking face is a risk marker. It’s not a symptom of dementia.
The 2024 Alzheimer’s Study: Fewer Smiles and Slower Emotional Responses
A third study from 2024 looked at facial changes in early Alzheimer’s disease using highly sensitive software. It confirmed again that people with Alzheimer’s disease:
- smiled less often
- had slower emotional responses
- had some facial movements that were slower, smaller or more rigid
These are changes in brain-driven motor and emotional function. Again, nothing obvious to someone just watching.
So this research is promising for future clinical tools that could help identify dementia earlier. But these aren’t things to look for yourself to try to diagnose somebody at home.
What Facial Changes Mean, and What They Don’t
What this research means is something we already know. Dementia affects far more than memory. It changes motor control and expression, and biological aging can show up early in how we look.
Many of the earliest signs aren’t about memory at all, which I go through in early warning signs of dementia families often miss at first.
What it doesn’t mean:
- We can’t diagnose dementia by looking at somebody, or by their facial expressions.
- Family members shouldn’t use this information as a screening tool to figure out whether their loved one has dementia.
- Not everybody who looks older than their age is at risk for dementia.
These are early studies. Scientists are doing this work in hopes of detecting Alzheimer’s disease and other dementias earlier. Because the earlier we detect them, the earlier we can intervene, and the more options there are for treatment, for interventions, and for getting families as prepared as possible for what’s ahead.
When Your Loved One With Dementia Doesn’t Smile Like They Used To
Many times family members tell me their loved one has less expression and fewer smiles. They seem flatter. They don’t react emotionally the way they used to.
This research hopefully validates your experience.
Around the holidays, so many families I work with have such high hopes of giving their loved one with dementia a beautiful holiday. And it can feel pretty defeating when your loved one doesn’t show excitement, appreciation or happiness for the gift they received, the show they went to, or the visitor who stopped by.
That doesn’t necessarily mean your loved one isn’t enjoying what’s happening. It means dementia is affecting their facial movements and their ability to show expression.
Just because it doesn’t look a certain way on the outside doesn’t mean that’s how they’re feeling on the inside. The brain just isn’t moving the face the way it does for you and me.
So, Can Facial Changes Be an Early Sign of Dementia?
Yes, there is emerging research on how early changes in facial expression might help us identify dementia earlier.
But no, we’re not at the stage where we can look at somebody’s face and determine whether or not they have dementia. Certainly not with the naked eye.
If you’re looking for more support while you care for your loved one, we are here for you. Inside the Care Collective, you have a community of loving, supportive Careblazers and a panel of dementia experts you can come to week after week for support and answers to your questions. You can learn more here.
