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Symptoms and Signs of A Caregivers' Challenge: Dealing with "Sundowning" in Alzheimer's Disease

Doctor's Notes on A Caregivers' Challenge: Dealing with "Sundowning" in Alzheimer's Disease

"Sundowning" (or "Sundown Syndrome") refers to changes in behavior and mood that frequently occur in the late afternoon or evening in people with Alzheimer's disease and similar conditions that alter brain function. These changes in mood and behavior can affect the quality of life for the patient and also be challenging and exhausting for caregivers and loved ones. It's not clear why these behaviors tend to occur at night and in late afternoon.

Symptoms of sundowning include aggression, agitation, delusions, hallucinations, paranoia, increased disorientation, wandering or pacing, becoming demanding, impulsiveness, difficulty understanding others, attempting to leave home, and difficulty with tasks that were done without difficulty earlier in the day. “Shadowing” can also occur along with sundowning, in which the person mimics or follows the caregiver, sometimes asking repetitive questions.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.