This woman's picture reminds me of my mother-in-law a great deal. I met her when she was 42. She was still doing fairly okay at that time. She used to do her hair and change her clothes regularly, etc. Her hair was beautiful, natural spiral curles, which she dyed blond.
Within the first 2 years I knew her, she declined rapidly. She stopped brushing her hair, bathing, etc. That was the first time her hair became to the point we had to start cutting it out to get the matts out. Since then she has continued to decline. In fact, she had to go to court when her ex husband divorced her. She showed the judge a picture of herself when he first abandoned her after she became disabled, (which was a few years before I met her,) compared to herself at that time. It was part of the reason the judge sentanced her ex abandonment.
Even farther back, the pictures of her as a young woman she was a fully put together young professional. She ran the entire department of home health care at the hospital she worked at, (she was a high school drop-out who ended up a success story, very motivational.) Now it's an impressive thing to get her to go the grocery store.

And she has 0 confidance any more.