I find it pretty ironic that Dunaway was cast to play Katharine Hepburn, who was attractive but not someone I would call classically Hollywood Beauty. She had always a very androgynous look with fairly masculine features. And what I can tell, she never was big into plastic surgery and had never this overstretched look going on in her Senior years. Opposite to dear old Faye, who is touted as plastic surgery disaster for decades.
And my theory is, that it is a combination of cunty behavior she was already known for, a mental illness, and the fact that she is now an old Hollywood Hag who has trouble remembering her lines (if early signs of dementia or simply age, who knows...)
There is sometimes the misconception that people will get mellow as they age. That's not always true. More often than not they grow into really gigantic assholes. I compare it with a stone being hollowed out by a waterstream. The cuntiness goes deeper and deeper as the years pass by.