‘Sundowning’ is not very well understood (stock image) (Image: DBenitostock via Getty Images)
A psychologist has explored an often-missed indicator of dementia and precisely how patients can address it. The sign tends to be especially prominent in the afternoon and may initially prove challenging for family members to understand.
Dr Kellyn Lee, CEO of The Dementia Care Hub and Visiting Academic at the University of Portsmouth, outlined in a TikTok video during 2025: « So, this can happen at any time of day, but what we see a lot with people living with dementia is that it can happen in the afternoon. »
She then added: « So, what I would be looking at is this would be, again, a symptom of anxiety and agitation and maybe increased confusion. » Dr Lee is describing a condition called ‘sundowning’, which characterises increasingly erratic behaviour in dementia sufferers from midday onwards into the evening.
During these hours, a person may grow notably distressed while potentially suffering delusions or hallucinations too. Whilst the precise triggers remain unclear, the Alzheimer’s Society suggests it isn’t necessarily connected to sunset itself.
Rather, sundowning is typically associated with unfulfilled requirements at that particular time. These may include the following:
- Mood disorders, including anxiety and depression
- Hunger, pain or other unmet physical needs
- Disturbed hormone levels
- Side effects of prescribed drugs
- Sensory impairment, including sight loss
- Disturbance to the person’s ‘body clock’ caused by damage to the brain
- Overstimulation during the daytime
- Overtiredness
- Lack of exposure to sunlight
- Lack of interaction with other people or carers (if relevant)
« Sundowning can happen at any stage of dementia but is more common during the middle stage and later stages, » further advice from Alzheimer’s Society adds. It then continues: « Think whether something that’s happened during the day has affected them. If they seem agitated, try to calm them by distracting them, perhaps talking about a favourite memory or event they enjoy thinking about. »
If you are concerned that your loved one is experiencing sundowning, Dr Lee also advised noting the symptoms at different times of day. In her explanation, she continued: « So, what I would be looking at doing is noting down when this is happening and what’s happening. There are tablets that can be used, such as lorazepam.
« Absolutely these drugs are drugs that need to be taken with caution because they are highly addictive. So, some GPs may not want to prescribe them.
« However, I think we really need to balance the risk of addiction compared to the fact the person has dementia. »
Other potential indicators of dementia
Dementia is an umbrella term covering numerous health issues, including Alzheimer’s disease, all characterised by a gradual deterioration in cognitive function. NHS figures reveal that more than 944,000 people across the UK are presently living with dementia.
Signs of dementia differ according to the specific type, but early indicators frequently include:
- Mood changes
- Difficulty concentrating
- Finding it hard to carry out familiar daily tasks, such as getting confused over the correct change when shopping
- Memory loss
- Struggling to follow a conversation or find the right word
- Being confused about time and place
NHS guidance adds: « These symptoms are often mild and may get worse only very gradually. It’s often termed ‘mild cognitive impairment’ (MCI) as the symptoms are not severe enough to be diagnosed as dementia.
« You might not notice these symptoms if you have them, and family and friends may not notice or take them seriously for some time. In some people, these symptoms will remain the same and not worsen. But some people with MCI will go on to develop dementia.
« Dementia is not a natural part of ageing. This is why it’s important to talk to a GP sooner rather than later if you’re worried about memory problems or other symptoms. »
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