Notice This in the Late Afternoon? Get Checked for Dementia, Says Mayo Clinic
The term "dementia" describes over 100 different conditions that impair memory, thinking, and behavior. Because it's a broad term used to capture so many different cognitive impairments, it can be hard to pinpoint its symptoms. However, there are some red flags that can let you know that it's time to schedule a dementia screening. Among them is one symptom that occurs in the late afternoon or evening, according to the Mayo Clinic. Read on to find out which symptom to look out for and what to do if you suspect a problem.
Everyone gets anxious, overwhelmed, or confused from time to time, but if you notice that this occurs in the late afternoon or early evening on a regular basis, the Mayo Clinic recommends being screened for dementia.
That's because many people with dementia or Alzheimer's disease experience a phenomenon known as "sundowning," a heightened state of disruptive behaviors in the evening hours. "These behaviors represent a wide variety of symptoms such as confusion, disorientation, anxiety, agitation, aggression, pacing, wandering, resistance to redirection, screaming, yelling and so forth," according to a 2011 study published in the journal Psychiatry Investigation. The study's authors add that "mood swings, abnormally demanding attitude, suspiciousness, and visual and auditory hallucinations" are also considered clinical features of sundowning.
Though experts are aware that sundowning is a fairly widespread phenomenon among dementia patients, the condition's root cause remains unclear.
"It may have to do with the dimming light—a sense that it's time to change activities or 'go home'—or other factors, including extreme fatigue, hunger, thirst, pain or discomfort, or hormonal changes that occur as the sun goes down," explains the American Association of Retired Persons (AARP). "Evening and darkness may tap into fears of being unsafe and insecure."
Additionally, the Psychiatry Investigation study explains that a reduction in melatonin production likely plays a role in the prevalence of sundowning.
Certain factors may exacerbate the effects of sundowning among those with dementia, the Mayo Clinic explains. Fatigue or disruption of one's usual sleep schedule, for example, may put an added strain on the body's internal clock, as can low lighting and increased shadows.
Additionally, the presence of a urinary tract infection may trigger more pronounced sundowning symptoms. This can become a hurdle to wellness in geriatric dementia patients, who are far more prone than their younger counterparts to develop such an infection.
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If you do notice symptoms of sundowning, however subtle, the first step is to contact your medical care provider. They may be able to help you establish a plan for reducing symptoms. According to the Mayo Clinic, behavioral interventions frequently include maintaining a predictable routine for bedtime, waking, meals, and activities; being regularly exposed to light during the day for better nighttime rest; limiting caffeine intake; and minimizing nighttime stimulation, among others.
Additionally, certain treatments may help lessen sundowning symptoms. "Bright light therapy, melatonin, acetylcholinesterase inhibitors, N-methyl-d-aspartate receptor antagonists, [and] antipsychotics," may all be useful tools for your doctor to consider, the Psychiatry Investigation's authors note.