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Why do some Alzheimer disease symptoms become worse at night?
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Alzheimer disease
Histopathologic image of neuritic plaques in the cerebral cortex in a patient with Alzheimer disease of presenile onset (onset before age 65).
The phenomenon where symptoms of Alzheimer disease and other forms of dementia worsen in the late afternoon or evening is known as sundowning.1
This state is characterized by increased agitation, confusion, disorientation, and anxiety as the day transitions into night. While the exact biological mechanisms are complex, it is often associated with the progression of the disease, affecting up to two-thirds of patients. Environmental factors, such as the shorter daylight hours during winter months, can also increase the risk of these episodes.1
It is important to approach those experiencing sundowning with patience and compassion, as these symptoms represent a significant challenge for individuals living with dementia and their caregivers.1