A “common” symptom of dementia could occur in the afternoon and evening. Experts warned that this lesser-known warning sign of the condition could lead to “anxiety and agitation”.

A symptom of dementia, often overlooked, tends to manifest during the late afternoon and evening hours. Experts caution that this lesser-known sign can provoke feelings of “anxiety and agitation.”

Dementia, a syndrome that encompasses a range of symptoms, is linked to the gradual decline in brain function. While many recognize symptoms like memory loss, other signs remain less familiar.

One such issue is known as sundowning. As reported by Dementia UK, this phenomenon is a “common symptom” impacting approximately 20% of individuals with dementia.

The organization explains on its website: “Sundowning is a frequent symptom of dementia.”

“It is thought to affect about 20% of people with dementia, often due to tiredness, unmet needs (like hunger or pain), a lack of daytime activity or natural light or environmental changes. Sundowning can often be managed using strategies that include identifying triggers and patterns for the person’s anxiety, using calming techniques and distraction, and maintaining a consistent daily routine.”

Why does sundowning happen?

There are many possible reasons why sundowning may occur. These include:

• Tiredness
• The person having unmet needs that they cannot express, eg hunger or thirst
• being in physical pain
• A lack of activity or exposure to natural light during the day
• Overstimulation during the day, such as being in a noisy, busy environment
• Hormonal changes towards the end of the day
• Medication side effects
• Changes in the person’s body clock that occur in some types of dementia, such as Lewy body dementia
• Environmental changes like streetlights coming on or people settling in for the evening, which can trigger a sense of being in the wrong place
• The person’s family members being tired and less able to meet their needs
• Fewer care staff being on shift in a care home to support the person

It is believed to affect about 20% of those with dementia, often due to factors such as fatigue, unmet needs (like hunger or pain), insufficient daytime activity or natural light, or changes in the environment. Sundowning can often be managed by identifying triggers and patterns in the individual’s anxiety, employing calming techniques and distractions, and maintaining a consistent daily routine.”

What are the signs and symptoms of sundowning?

Confusion

Dementia UK said: “Sundowning often makes a person with dementia feel very strongly that they are in the wrong place. They might say they need to go home, even if they are at home, or think they need to pick their children up from school, even if they are now adults. They might believe they have to go to work, even if they are retired.

“The person might become confused about who people are or what is going on around them. They might ask the same questions repeatedly, for example, ‘When will you take me home?’”

“The sense of intense confusion that comes with sundowning typically makes the person with dementia feel very unsettled and anxious,” it said.

Dementia UK said: “A person who is sundowning might show agitated behaviour such as restlessness, fidgeting (for example plucking at their clothes or skin), irritability, shouting or arguing. They might follow a family member, pace or walk around – this might seem aimless, but they may be trying to fulfil a need like finding someone they remember or getting something to eat.

“They might put their shoes and coat on and try to leave their home.”

For more advice, including how to support someone who is experiencing sundowning, visit the Dementia UK website here. If you or someone you know is displaying signs of dementia, you should speak to a GP.