A psychologist has shed light on a lesser-known dementia symptom that tends to intensify during the afternoon, often leaving carers perplexed. Dr Kellyn Lee, who leads The Dementia Care Hub, described the phenomenon known as 'sundowning', where patients display increasing agitation, anxiety and confusion in the late afternoon and early evening.
In a TikTok video earlier this year, Dr Lee explained: '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. So, what I would be looking at is this would be, again, a symptom of anxiety and agitation and maybe increased confusion.' She noted that during such episodes, patients may become exceptionally distressed and could experience hallucinations or delusions.
While the precise triggers for sundowning are not fully understood, the Alzheimer's Society suggests it is not necessarily linked to dusk but rather to unmet needs such as hunger, thirst, pain, boredom, or needing the toilet. The charity advises that sundowning can occur at any stage of dementia but is more common in the middle and later stages.
Dr Lee recommends that carers keep a log of symptoms and their timing to help identify patterns. She also mentioned that medications like lorazepam can be used, but cautioned: '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.'
Common early signs of dementia include memory loss, difficulty concentrating, confusion about time or place, and mood changes. The NHS encourages anyone experiencing these symptoms to seek medical advice, noting that while there is no cure, treatments can help manage symptoms temporarily.
