Sundowner’s Syndrome

The Alzheimer’s Association explains, “Sundowner’s syndrome” or “sundowning” is a set of symptoms or behaviors that are found in some people with Alzheimer’s disease and dementia. The syndrome’s symptoms include agitation and anxiety, and it occurs in the later part of the day and evening with marked behavior changes in the person.

Fred Kobylarz, MD, co-director of the Center for Healthy Aging at Rutgers Robert Wood Johnson Medical School says it is not a disease, but rather a symptom of dementia. While doctors do not know the cause of sundowning, they believe it may be a “combination of hormonal changes, brain deterioration or damage that has occurred, environmental factors, disruption to a person's circadian rhythm, and more.”

The syndrome may start as early as 1 p.m. in some people but usually is later in the day. Along with agitation and anxiety; symptoms can include things like pacing, disorientation, hallucinations and problems sleeping. Other behavior changes may include angry outburst and aggressive, sometimes even physical altercations. Others just want to be closer to a person they trust as they need reassurance. Some people do not remember what happened earlier in the day and even forget they just ate dinner and want to eat again.

Experts say in some cases sundowning starts before a person has had a diagnosis of Alzheimer’s or another form of dementia. However it is not only found in people with dementia as some older adults exhibit symptoms during an illness or period of delirium.

Doctors recommend families who suspect Sundowners to consult with their healthcare provider to rule out other causes. Guidelines for managing the syndrome include setting up a schedule that adheres to their needs and maintaining a consistent daily routine to reduce confusion and fatigue. During morning hours encourage the person to do activities that increase their exposure to natural light to help support better sleep-wake cycles. Avoid over stimulating the person in the evenings and don’t subject them to crowds, bright screens or loud noises.

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Source: womenshealthmag.com/health/a63084354/sundowning-dementia-sign/