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Anthea Rowan

This is the 45th instalment in a series on dementia, including the research into its causes and treatment, advice for carers and stories of hope.
William Shakespeare described the eyes as the window to the soul.
It turns out that they are much more than that: they can offer a view of our overall health, and a regular eye exam can pick up a host of illnesses.
Marfan syndrome, for example, is a genetic disorder that affects connective tissue – the fibres that support and anchor the organs and other structures in the body.
It most commonly affects the heart, eyes, blood vessels and skeleton. It is visible in sufferers’ eyes as long stringlike tissues that hold their lenses in place. This alerts doctors to check for aortic wall weaknesses in the heart.

Thyroid disease is evident in a bulging eye. Cancer of the eye can be seen as black spots at the back of the eye – a growing and potentially fatal melanoma if not spotted early.
The signs of high blood pressure might appear in the eyes as bends or tiny tears in the small vessels of the eye.
Blurred vision usually means you need a new prescription for lenses or glasses – or that you need to start wearing glasses. But it can also point to things like diabetes. In one study, 73 per cent of the diabetic patient participants being monitored reported blurred vision.
The retina, at the back of the eye, might show the warning signs of heart disease; stroke risk can be found in the eye, too – blocked blood vessels in the eye could indicate blocked blood vessels in other parts of the body.
Brain illnesses and injuries can be spotted in the eye – sometimes early enough to make a big difference. Because the optic nerve is an extension of the brain, an eye exam may flag a neurological condition.

As Dr Thomas Wilcockson, a senior lecturer in psychology at Loughborough University in the UK observes, the eyes are “the window into the brain”. And, he adds, “measuring the way we control our eyes may provide us a non-invasive way of determining brain health”.
Wilcockson and his team recently published a study that found there could be clues in eyes – “a loss of visual sensitivity” – that could predict dementia 12 years before it manifested in those awful symptoms of decline.
The research – which included almost 9,000 participants who were followed up for many years – began with a visual sensitivity test: they had to press a button in response to a particular image forming on a screen. The data showed that those who responded slowly went on to develop dementia later.
Amyloid beta, one of the markers of Alzheimer’s disease, is thought to begin by damaging the brain near regions associated with controlling eye movement, Wilcockson says. That is why deficiencies in eye movement may be an early marker of Alzheimer’s.
What is the link between eye movement and brain health and memory? It is thought that horizontal eye movements boost memory by stimulating communication between brain hemispheres.
Wilcockson explains: “Rapid eye movements might force these hemispheres to work together, leading to better memory retrieval.”

Some studies have found that this sort of rapid – and repetitive – horizontal eye movement might improve autobiographical memory.
That may explain why people who watch more TV and read more have better memory and less dementia risk than those who do not, he suggests.
While eyes may help to predict brain health – even prevent the brain drain that comes with dementia – being able to see well is both necessary for, and extends, brain health.
Untreated visual loss is the latest modifiable risk factor to be added to the updated Lancet Commission’s list of dementia risk factors last month. Whether watching a film or reading a book to benefit from that repetitive, rapid eye movement, you obviously need good vision – or glasses.
What does “untreated” visual loss mean? Professor Gill Livingston, an author of the Lancet reports, says it refers to “anything which impairs vision”. Anything.

Untreated visual loss is a risk for dementia, she says, because it robs the brain of stimulation through reading or watching a movie or television, and also because it restricts physical and social activities.
Livingston says the global prevalence of avoidable vision loss and blindness, including common sight problems for which glasses are prescribed, in adults aged 50 years or older, is estimated to be 12.6 per cent.
It is much more prevalent in low- and middle-income countries than in high-income countries where vision tests are often more easily available, she adds.
Of course, the primary reason for a sight test is just that: to check your sight and the health of your eyes. Many people’s sight is improved with spectacles (if I did not have mine, I would not be able to read, drive, watch TV or work). Sight is often saved with – for example – an early diagnosis of intraocular pressure which could lead to glaucoma; this is easily treated with drops but, if left untreated, can lead to blindness.
Cataracts are another common condition that might be picked up in the eye exam.
We want to demonstrate that eye movements can be an effective way to predict dementia. We aim to develop cheap and efficient ways of monitoring eye movements
Dr Thomas Wilcockson, senior lecturer in psychology, at Loughborough University
These may begin to form when you are in your 40s – the proteins in the eye lenses start to break down, which causes the lens to cloud. They are common; more than half of all Americans have had a cataract removed by the time they are 80.
In Hong Kong, at the end of June 2024, there were 69,438 people booked for cataract surgery on the waiting list in the public hospital system, with a waiting time of 10 to 31 months depending on the district.
That simple surgery may help protect brains: one US study found that people who had cataract extraction surgery had significantly reduced dementia risk compared with those who did not.
This is what drives Wilcockson’s research.

“We want to demonstrate that eye movements can be an effective way to predict dementia,” he says. To that end, he adds: “We aim to develop cheap and efficient ways of monitoring eye movements so that these measures can be used more widely.
“Then, with lifestyle change interventions, we may be able to delay or even prevent dementia progression.”
And to do that you need good sight.
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How air pollution increases dementia risk and ways to limit your exposure

Wellness

How watching TV and reading could safeguard brain health, and why you need an eye exam

Your eyes are windows into your physical and mental health, and an eye test can reveals symptoms of multiple conditions, from high blood pressure to diabetes and dementia. Photo: Shutterstock

An eye exam can reveal much about a person’s overall health, even whether they have high blood pressure. Photo: Shutterstock

“Measuring the way we control our eyes may provide us a non-invasive way of determining brain health,” says Dr Thomas Wilcockson, a senior lecturer in psychology at Loughborough University, in the UK. Photo: Loughborough University 

People who watch more TV and read more have better memory and a lower dementia risk than those who do not, a new study suggests. Photo: Shutterstock

There could be clues in eyes – a loss of visual sensitivity – that predict dementia 12 years before it manifests in memory loss. Photo: Shutterstock

Thomas Wilcockson performs an assessment of a participant’s eyes, using tools to track eye movement. Photo: Loughborough University 

Ozempic, other weight-loss drugs help with heart attack, stroke, fertility. Dementia next?

Many of the new weight-loss drugs can by extension alleviate other health conditions. Photo: Shutterstock

Ozempic and similar new weight-loss drugs also lower the risk of heart attack, stroke, kidney and liver disease, and some increase fertility. The mechanism they use to target parts of the body could be applied to dementia treatment, researchers hope. Photo: Shutterstock                                                       

With more than a billion obese people on the planet, Clemmensen says at least 10 effective drugs that work in different ways are needed. Photo: Shutterstock

There have been reports of a so-called Ozempic baby boom after many women who were overweight and believed to be infertile became pregnant after losing weight with the help of new weight-loss drugs. Photo: Shutterstock 

Christoffer Clemmensen, of the Novo Nordisk Foundation Centre for Basic Metabolic Research at the University of Copenhagen, says weight-loss drugs introduced recently are not perfect. Photo: Christoffer Clemmensen

Christoffer Clemmensen’s team is researching how they might use the same GLP-1 receptor found in new weight-loss drugs to “smuggle” a drug into mice brains that targets neurons responsible for appetite control. Photo: Shutterstock

Ageing speeds up at 2 points in your life. Experts share things you need to be aware of

A study shows increases in the rate of ageing of our bodies at two points in our lives. One effect is that we become less effective at metabolising the caffeine in coffee. Photo: Shutterstock

People become less effective at metabolising alcohol at the age of about 40 – and even less so at age 60 – a study suggests. Photo: Shutterstock

Muscle injuries were found to be more common at the ages of about 44 and 60 in participants in the study. Photo: Shutterstock 

Sleeping in on weekends could help protect your heart, study on compensatory sleep says

Catching up on sleep at the weekend could lower your risk of developing heart disease by nearly 20 per cent, new research finds. Photo: Shutterstock

Sleeping in on the weekends could lower your risk of developing heart disease by nearly 20 per cent, new research finds. Photo: Shutterstock

The study also looked at a subgroup of people with daily sleep deprivation – defined as having less than seven hours of sleep a night. Photo: Shutterstock

Lifestyle

Health & Wellness

Health

Decoding dementia

How caring for a parent with dementia taught me about symptoms, prevention and why seeking out the latest research is so important

Author Anthea Rowan (right) with her mother.

Author Anthea Rowan (right) with her mother, who has Alzheimer’s disease, the most common type of dementia. Photo: Anthea Rowan

Anthea with her mother. Photo: Anthea Rowan

Studies suggest that regular exercise lowers the risk of cognitive decline by 35 per cent. Photo: Getty Images

Staying active can help prevent or delay the onset of dementia, studies suggest. Photo: Shutterstock

Why should you have a brain scan to test for dementia when there’s no cure? Knowing can help you delay its onset, neurologist says

It can be daunting to get a brain scan to test for signs of dementia, but a neurologist behind new research reveals the advantages of knowing early. Photo: Shutterstock

New research has found that dementia can be detected as early as nine years before symptoms manifest, and this could have significant implications for treatment. Photo: Shutterstock

Timothy Rittman, the neurologist who led the dementia research at Cambridge University. Photo: Cambridge University

A brain scan showing signs of dementia. Photo: Getty Images

Lizzie Perry, founder of This is Dementia, with her father, who was diagnosed with the disease at 58. Photo: This is Dementia

The approval in the US of a new drug that slows the onset of Alzheimer’s makes Rittman hopeful about the future of dementia treatment. Photo: Cambridge University

Why women are more likely to have dementia than men as they age, and how exercise and engagement can help lower your risk

Women may be at a greater risk of developing Alzheimer’s than men for a number of reasons: biological, societal or cultural. Experts suggest exercise and social engagement can help offset the risk. Photo: Getty Images

The spread of tau – the protein that clumps into the telltale tangles of dementia – may contribute to Alzheimer’s disease. Photo: Shutterstock

Female twins with a male co-twin were less likely to be diagnosed with dementia than female twins with a female co-twin. Photo: Shutterstock

Prenatal care and monitoring pregnant women’s health is key, as it may impact cognition and dementia risk in later life. Photo: Shutterstock

Taking regular exercise is key for women – and men – to reduce the risk of dementia. Photo: Shutterstock

How high or low blood pressure increases the risk of dementia, and why it’s never too late, or early, to adopt a healthy lifestyle to manage it

Having blood pressure that is too high or too low has been linked to a higher risk of dementia, but it’s never too late to start living a healthy lifestyle that will help maintain optimal blood pressure. Photo: Shutterstock


An optimal blood pressure reading, easily measured with a home device, is around 120/80. Photo: Shutterstock

Dr Ruth Peters was lead author of a study looking at the links between blood pressure and dementia. Photo: Dr Ruth Peters

It’s never too late, or too early, to start thinking about brain health and living a healthy lifestyle. Photo: Shutterstock

Problems with reasoning, planning, judgment, memory and other thought processes may result from damage caused by impaired blood flow to the brain – which may be brought on by high blood pressure. Photo: Shutterstock

6 dementia fighting tips from Dr Sanjay Gupta and Marc Milstein, experts on brain health – walk, talk, read, learn, relax, and eat and drink properly

We can protect ourselves against the risk of dementia with some simple lifestyle practices. Exercising (above), eating a good diet, drinking less alcohol, socialising, reading more and trying new things all help keep the brain sharp, say brain experts including Dr Sanjay Gupta. Photo: Shutterstock 

The cover of one of Dr Sanjay Gupta’s book. Photo: Simon & Schuster

The cover of Marc Milstein’s book. Photo: Marc Milstein

Drink alcohol mindfully and ask yourself why you are having that drink. Photo: Shutterstock

Learning new things creates new brain cell connections and helps keep your mind sharp. Photo: Shutterstock

Reading is good for brain health. Try to read a wide range of book styles, and join a book club to discuss with others what you are reading. Photo: Shutterstock

During sleep, our brains are restored and repaired, so relaxing is important if we’re going to get those seven hours of quality sleep. Photo: Shutterstock

Relationships keep us engaged, interested and interesting, and may help prevent dementia. Photo: Shutterstock

‘Like a light switch’: how sundowning syndrome affects dementia sufferers – and their carers; what it is and tips for how to cope

A person with dementia may experience “sundowning” syndrome - towards the end of the day they become more agitated, confused, panicked, resistant to instruction and restless. This affects their carers, too. Photo: Shutterstock

A person in bed, unable to sleep. Conservative estimates suggest about 20 per cent of dementia patients experience sundowning at some point.

Trey Todd is a neuroscientist at the University of Wyoming. Photo: Trey Todd

Sundowning was coined in 1987 by Lois Evans of Penn Nursing at Pennsylvania University. Photo: University of Pennsylvania

The pineal gland in our brain produces melatonin, which is what helps prompt us to sleep and awaken. In a broken system it is disrupted. Melatonin supplements might help fight sundowning. Photo: Shutterstock

Taking a patient with sundowning syndrome for a walk at a consistent time each day, morning or evening, may alleviate symptoms. Photo: Shutterstock

Getting out into the daylight early in the day is good for our sleep patterns, whether we have dementia or not. Photo: Shutterstock

Healthy marriage, healthy mind? Dementia risk lower for people married a long time, studies show; expert suggests why

Research suggests that people who have stayed married for a long time have a lower risk for dementia because they feel less lonely, are more likely to eat well and exercise more, and are more cognitively engaged. Photo: Shutterstock

Vegard Skirbekk is a researcher at the Norwegian Institute of Public Health. Photo: Norwegian Institute of Public Health

Anthea Rowan’s parents on their wedding day. Photo: courtesy of Anthea Rowan

A long-time married partner represents a security that provides a buffer against stressors. Photo: Shutterstock

Anthea Rowan and her husband on their wedding day. Photo: courtesy of Anthea Rowan

If you live with a partner long term, you are more likely to develop healthy daily patterns, to eat well and exercise more. Photo: Shutterstock

‘Dementia village’ that’s the first of its kind helps residents live normal lives, has a restaurant, theatre and supermarket – and no one wears a white coat

Residents are free to live their lives as they like at the world’s first “dementia village”, The Hogeweyk in The Netherlands. Photo: The Hogeweyk

The Hogeweyk, a “dementia villlage” in the Netherlands, provides care and a familiar and safe environment in which people with dementia live while retaining their own identity and autonomy as much as possible. Photo: The Hogeweyk

Jannette Spiering is the senior managing adviser and co-founder at The Hogeweyk in the Netherlands, which offers “humanising care for people with dementia”. Photo: The Hogeweyk

Residents relax around the fountain in the theatre square at The Hogeweyk. Photo: The Hogeweyk 

Residents of The Hogeweyk respond positively to their increased autonomy. Photo: The Hogeweyk

Residents at the healthcare facility take part in a painting class. Photo: The Hogeweyk

Hearing loss dramatically raises the risk of dementia, so why are so many people in midlife doing nothing to prevent it? A test is easy to arrange

Hearing loss has been linked to a higher risk of dementia and cognitive decline,  say experts, who recommend testing for preventable hearing problems (above).  Photo: Getty Images

Alison Huang, a senior research associate at the Cochlear Centre at Johns Hopkins, in the US, says hearing loss makes the brain work harder to process sounds. Photo: Johns Hopkins

Jiang Fan from the School of Public Health at China’s Shandong University. Photo: Shandong University

Checking your hearing in midlife is crucial, and can help you stave off cognitive deterioration. Photo: Shutterstock

Can HRT reduce dementia risk? New hormone replacement therapy studies say yes, upending 2002 reports

HRT use has been linked to better cognition, blood flow and brain size and a reduction in all neurodegenerative disease in recent studies. Photo: Shutterstock

HRT (hormone replacement therapy) use has been linked to better cognition, blood flow and brain size and a reduction in dementia and other neurodegenerative disease in recent studies. Photo: Shutterstock

If HRT is started after the age of 65, brain cells will have already been deprived of oestrogen for many years. This could mean there is a decline in neuronal connections – the brain’s messaging system. Photo: Shutterstock

HRT was found to be most effective when introduced early in menopause, says Anne Marie Minihane, director of the UK’s Norwich Institute of Healthy Ageing at the University of East Anglia. Photo: University of East Anglia

Dr Andrea Kwakowsky from at the University of Galway in Ireland believes the “critical period” for starting HRT is within five years of menopause. Photo: University of Galway

How can you prevent dementia? Free brain health online tool teaches the risks and gives essential tips on avoiding it

The new free “Think Brain Health Check-in” online tool from Alzheimer’s Research UK doesn’t test your memory but checks how well you’re looking after your brain and gives tips to help prevent dementia. Photo: Shutterstock

Dr Susan Mitchell is head of policy at Alzheimer’s Research UK. Photo: Dr Susan Mitchell

The Think Brain Health Check-in asks how often you challenge your brain - and then highlights why challenging your brain is key to staving off dementia. Photo: Shutterstock

Getting a good night’s sleep every night is one way to lower the risk of developing dementia. Photo: Shutterstock

Up to 40 per cent of dementia cases could be prevented if people were mindful of the risk factors for the illness and made lifestyle changes to prevent them. Photo: Shutterstock

Can lack of sleep raise dementia risk? Yes, studies say – but with one exception

Having only five hours of sleep a night can increase dementia risk by 30 per cent for adults over 50, one study says. Photo: Shutterstock

One tip to overcome insomnia is to avoid clock-watching. Photo: Shutterstock

Taking a warm shower or bath in the hour or so before bed may help you fall asleep – and stay asleep. Photo: Shutterstock

Professor Roger Wong of the department of public health and preventive medicine at the State University of New York’s Upstate Medical University. Photo: Roger Wong

Sleep aids can heighten dementia risk, Wong says. Photo: Shutterstock

Can’t sleep? Try getting up and engaging in cognitively stimulating activities, like reading or making jam. Photo: Shutterstock

Dementia and ACB scores: how common prescription and over-the-counter drugs raise the risk of memory loss and cognitive decline

Certain common drugs, including antihistamines, antacids, antidepressants and anti-anxiety medicines, can disrupt the neurotransmitter acetylcholine, dubbed the “memory molecule” increasing the risk of dementia. Photo: Shutterstock

The writer, Anthea Rowan, with her mother. Photo: Anthea Rowan

Taking medications that block the action of acetylcholine can lead to memory loss, problems with spatial awareness, and cognitive decline. Photo: Shutterstock

Studies have found that anticholinergic drugs carried “significant’ dementia risk” for the over-65s. Photo: Shutterstock

Doctors need to be mindful of the risks posed by anticholinergic drugs, especially to an already at-risk population: the over 65s. Photo: Shutterstock

How to safeguard your ageing brain: build ‘cognitive reserve’ with mental and physical exercise, and stay active and socially engaged

The phrase ‘use it or lose it’ is not just a hypothesis, it’s a basic biological fact that holds as true for our brains as our muscles or bones. Photo:
Shutterstock

Our brains, like our muscles need regular use to stay healthy and flexible, say experts, and keeping our brains active builds our ‘cognitive reserve’, helping us to stave off dementia. Photo: Shutterstock

Geriatric psychiatrist Dr David Merrill recommends the active pursuit of activities that keep the brain sharp to stave off dementia. Photo: Dr David Merrill

Dorina Cadar says cultural and social engagement, reading, doing crossword puzzles, visiting art galleries, clubs and cinemas, and volunteering all increase our cognitive reserve. Photo: Dorina Cadar

Visiting an art gallery or doing something new and different are good ways to build up cognitive reserve. Photo: Shutterstock 

How yoga benefits dementia patients: new study uncovers brain-health boosts, supporting earlier research

Yoga has health benefits including better brain neuroplasticity, improved sleep quality, and more robust cardiorespiratory fitness, all of which help people experiencing cognitive decline or dementia. Photo: Shutterstock

Dr Diana Karamacoska is a research support programme fellow in healthy ageing and dementia at the NICM Health Research Institute at Western Sydney University. Photo: Courtesy of Diana Karamacoska

Yoga could be helpful in managing brain inflammation, particularly with its mindfulness component. Photo: Shutterstock

Wendy Du is the founder of Shan Studios in Hong Kong. Photo: Wendy Du/Shan Studios

Du has maintained a daily yoga practice for 10 years. Photo: Courtesy of Shan Studios

5 nutrients good for brain health that can delay dementia, or prevent it, and foods to eat with a high concentration of them

Research has identified some key nutrients we need in our diets to maintain good cognitive function and delay or prevent the onset of dementia. Photo: Shutterstock

Eating healthy isn’t just good for our bodies, it’s good for our brains, too. Photo: Shutterstock

Zahinoor Ismail, of the O’Brien Institute for Public Health at the University of Calgary. Photo: University of Calgary

Kale with pine nuts is a dish high in magnesium, and so good for brain function. Photo: Shutterstock

Oatmeal, and other wholegrain foods such as brown rice and quinoa, are rich in magnesium. Photo: Shutterstock

Mackerel is a fish that is especially high in magnesium. Photo: Shutterstock

Why you have to keep smiling at a dementia patient – you’ll feel better and it could evoke a positive response

How watching TV and reading could safeguard brain health, and why you need an eye exam

An eye test can reveal many conditions, from high blood pressure to thyroid disease and diabetes, and predict dementia 12 years in advance