A "common" symptom of dementia could manifest in the afternoon and evening. Experts have cautioned that this lesser-known indicator of the condition could lead to "anxiety and agitation".

Dementia is a syndrome, or a group of related symptoms, associated with theprogressive decline of the brain. While many of us might be familiar with certain problems that accompany dementia, such as memory loss, others are less well-known.

Sundowning is one such issue. According to Dementia UK, it is a "common symptom" believed to affect around 20 per cent of dementia patients.

On its website, the charity explained: "Sundowning is a common symptom of dementia. It causes feelings of intense confusion, anxiety and agitation, typically in the late afternoon and evening, around dusk.

“It is thought to affect about 20 per cent 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 occur?

There are many potential reasons why sundowning may happen. These include:

• Tiredness


• The individual having unmet needs that they cannot express, such as hunger or thirst


• Experiencing physical pain


• A lack of activity or exposure to natural light during the day


• Overstimulation during the day, for instance being in a noisy, bustling environment


• Hormonal changes towards the end of the day


• Side effects of medication


• Changes in the person's body clock that occur in certain types of dementia, like Lewy body dementia


• Environmental changes such as streetlights illuminating or people settling in for the evening, which can trigger a sense of being in the wrong place


• The person's family members feeling tired and less capable of meeting their needs


• Fewer care staff on shift in a care home to assist the person

What are the signs and symptoms of sundowning?

Confusion

Dementia UK stated: "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?’”

Anxiety

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

Agitation

Dementia UK explained: "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.

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

For further guidance, including how to assist someone experiencing sundowning, visit the Dementia UK website here. If you or someone you know is exhibiting symptoms of dementia, it's important to consult with a GP.