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.

A psychologist has highlighted an often-overlooked symptom of dementia and provided insights on how patients can effectively manage it. This particular sign is frequently more noticeable in the afternoon, which can initially confuse and concern family members.

Dr. Kellyn Lee, CEO of The Dementia Care Hub and a Visiting Academic at the University of Portsmouth, shared her expertise in a TikTok video during 2025, stating, “While this can occur at any time of day, we often observe this phenomenon in the afternoon among individuals living with dementia.”

Dr. Lee elaborated, “What I would focus on is recognizing this as a symptom of anxiety and agitation, possibly accompanied by increased confusion.” She was referring to a condition known as ‘sundowning,’ which is characterized by escalating erratic behavior in dementia patients from midday into the evening hours.

During these periods, individuals may become significantly distressed and may also experience delusions or hallucinations. Although the specific causes of sundowning remain uncertain, the Alzheimer’s Society suggests that it is not necessarily related to the sunset itself.

• 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)

Instead, sundowning is often linked to unmet needs during those hours. These could involve various factors such as unmet physical or emotional requirements.

The Alzheimer’s Society further advises that sundowning can occur at any stage of dementia but is more prevalent during the middle to later stages. They recommend, “Consider whether any events during the day have impacted them. If agitation is evident, try to soothe them by redirecting their attention, perhaps by discussing a cherished memory or an event they enjoy recalling.”

“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.”