Dementia is a complex condition that affects the brain, leading to changes in memory, thinking, and perception. One lesser-known but distressing symptom that some people with dementia experience is a fear of mirrors or reflections. This fear can be deeply unsettling for both the individual and their caregivers. Understanding why dementia might cause this fear requires exploring how dementia affects the brain’s processing of visual information and reality.
Dementia can cause hallucinations and misinterpretations of what is seen. These hallucinations are more common in certain types of dementia, such as Lewy Body dementia and Parkinson’s disease dementia, but they can also occur in Alzheimer’s disease and other forms of dementia. The brain of a person with dementia may interpret sights and sounds differently from how a healthy brain would. This altered perception can lead to seeing things that are not there or misunderstanding what is seen, such as reflections in mirrors[1].
Mirrors and reflections can be confusing or frightening because the person with dementia may not recognize the image as their own reflection. Instead, they might see a stranger or a threatening figure. This misinterpretation can trigger fear or anxiety. For example, dim lighting or shadows can make reflections appear distorted or ghostly, increasing the sense of threat. Reflections in shiny floors, windows, or mirrors can seem like people are present when they are not, which can be very alarming for someone whose brain is already struggling to interpret reality correctly[1].
The fear of mirrors or reflections in dementia is often linked to hallucinations or illusions. Hallucinations are false sensory experiences, such as seeing people or objects that are not present. Illusions are misperceptions of real stimuli, like seeing a reflection but interpreting it as something else. Both can be caused by the brain’s impaired ability to process visual information due to the damage dementia causes. This damage affects areas of the brain responsible for recognizing faces and objects, leading to confusion and fear[1].
Environmental factors can also play a role in triggering fear of mirrors or reflections. For example, poor lighting, background noise, or unfamiliar surroundings can increase confusion and hallucinations. Caregivers are advised to check the environment for possible triggers and try to reduce them. Bright lights shining on mirrors or windows at night, for instance, can create confusing reflections that might scare someone with dementia[1].
Medical issues can exacerbate hallucinations and fears in dementia. Conditions such as dehydration, infections (like urinary tract infections), pain, or side effects from medications can worsen hallucinations or cause new ones to appear. If a person with dementia suddenly develops a fear of mirrors or starts seeing frightening reflections, it is important to consider whether an underlying medical problem might be contributing. Prompt medical evaluation is essential to rule out treatable causes and adjust medications if needed[1].
When addressing fear of mirrors or reflections in dementia, caregivers are encouraged to respond with simple reassurance rather than lengthy explanations. Complex reasoning may be difficult for the person to follow and can increase distress. Instead, calmly acknowledging their fear and providing comfort can help reduce anxiety. Tracking when these fears or hallucinations occur can also help identify patterns or triggers, allowing caregivers to modify the environment or routine to minimize episodes[1].
In summary, dementia can cause fear of mirrors or reflections primarily because the brain’s ability to interpret visual information is impaired. This leads to hallucinations or illusions where reflections are misperceived as threatening figures or strangers. Environmental factors and medical conditions can worsen these symptoms. Caregivers play a crucial role in managing these fears by creating a safe environment, offering reassurance, and seeking medical advice when necessary.
[1] DailyCaring, “Responding to Dementia Hallucinations in Seniors,” accessed December 2025.
