Doctor's Review: Medicine on the Move

October 26, 2021

© Herry Lawford /

Last September, de Kooning's Untitled XXV sold for over $66 million at a Christie's auction in New York.

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Cognitive decline in famous painters

Do fractals uncover disease?

Painter Willem de Kooning was an undocumented immigrant when he arrived in New York as a stowaway on a British freighter in 1927. Born in Rotterdam on April 24, 1904, he was to become the leader of American abstract expressionism in the 1950s. His series Woman epitomizes the form and his work continues to find wealthy buyers.

In September 2015, his painting Interchange was purchased, in a private sale, by hedge fund billionaire Ken Griffin for $300 million, the highest price yet paid for any painting.

This past September, Christie’s sold Untitled XXV at auction for more than $66 million, a record for the work of an abstract expressionist. It had previously been auctioned in 2006 and sold for $27.1 million.

His work is of special interest for another reason. Alex Forsythe, a psychologist at the University of Liverpool, has just published a paper based on the analysis of more than 2000 works by seven famous artists. She thinks she’s found a way of detecting changes in brushwork that indicate the beginnings of Alzheimer’s in painters in their 40s. De Kooning, who died in 1997 at the age of 92, had been diagnosed with the disease.

A second painter, James Brooks, the last of the original American abstract expressionists which also included Jackson Pollock, died in 1992 at the age of 85. His wife told the New York Times he had suffered from Alzheimer’s for the last seven years of his life.

Forsythe says she’s found signs of dementia in the works of both painters. Of the works she’s analyzed, those of Claude Monet, Pablo Picasso and Marc Chagall showed no signs of disease. Those of Salvador Dali and Norval Morrisseau indicated both had developed Parkinson’s.

Fractal tales

In her research, Forsythe used digital imaging software to calculate how fractal density varied in the artists’ paintings over their careers. And what precisely are fractals? Fractals are infinitely complex patterns that are self-similar across different scales. They are created by repeating a simple process over and over. Fractal patterns abound in nature and are found in the branching of trees and rivers, mountains, clouds, seashells and so on. (To learn more go to

In paintings, fractals appear when patterns made by the tiniest brush strokes are repeated on larger scales. The fractal dimension is a measure of fractal complexity where an artwork with a large fractal dimension has a high ratio of fine to coarse fractal patterns.

Forsythe found that paintings varied in their fractal dimensions over an artist’s career, but in the case of de Kooning and Brooks, the measure changed dramatically and fell sharply as the artists aged.

“The information seems to be like a footprint that artists leave in their art,” says Forsythe. “They paint within a normal range, but when something is happening the brain, it starts to change quite radically.”

Her research suggests that the fractal dimensions of paintings by Monet, Picasso and Chagall tended to rise as they aged. For Dali and Morrisseau’s work, the fractal dimension followed an upside down U-shape over time, at first rising and then falling. The starkest result was seen in the works of de Kooning and Brooks, where the fractal dimension started high and dropped rapidly from the age of 40.

Forsythe is not the first to look for early signs of dementia in writing and painting. In 2008, a team at the University of Toronto published a paper often referred to as “Three British Novelists,” which spotted early signs of dementia in the works of Agatha Christie and Iris Murdoch.

Researchers at Arizona State University used similar software to examine non-scripted news conferences of former presidents Ronald Reagan and George Herbert Walker Bush. President Reagan, they wrote, showed “a significant reduction in the number of unique words over time and a significant increase in conversational fillers and non-specific nouns over time,” while there was no such pattern for Bush. The researchers concluded that during his presidency, Reagan was showing a reduction in linguistic complexity consistent with what others have found in patients with dementia. Another study found similar results in autobiographical essays written by nuns in the ‘20s.

Yeas and nays

Richard Taylor, a physicist at the University of Oregon who pioneered the use of fractals, describes Forsythe’s work as a “magnificent demonstration of art and science coming together” and suggests it could be used more broadly to learn more about dementia.

For Taylor “the most inspiring message to come out of this work is that beautiful artworks can result from pathological conditions… these more simple works conveyed a peacefulness that wasn’t present in his nurture-dominated earlier work. It all goes to show that sometimes you can think too much about art. Sometimes you just need to tune into your inner self, the ‘nature’ part.”

Critics had suggested that when de Kooning was diagnosed with Alzheimer’s he should stop painting. Clearly Taylor does not agree. That said, another American physicist, Kate Brown at New York’s Hamilton College, calls Forsythe’s research “complete and utter nonsense.”

Forsythe concedes that the small number of artists involved in the study means the findings are highly tentative, but hopes that it will open up fresh avenues for investigating the disease. “I don’t believe this will be a tool for diagnosis, but I do think it will trigger people to consider new directions for research into dementia,” she says.

Forsythe’s paper, “What paint can tell us: A fractal analysis of neurological changes in seven artists,” appears in the journal Neuropsychology. Click here to read it.

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