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[Sundowning of the elderly person]
Lou Moeri1, Paul Mini1, Cristiano Gironi1,2
1Service de psychiatrie gériatrique, Département de psychiatrie, Hôpitaux universitaires de Genève, 1211 Genève 14.
Revue Medicale Suisse
|September 20, 2023
Summary
Sundowning, a worsening of neuropsychiatric symptoms in the elderly after dark, disrupts care. Current treatments lack proven effectiveness, and its cause remains unclear.
Area of Science:
- Geriatric Medicine
- Neurology
- Sleep Medicine
Context:
- Sundowning, or late-day confusion, significantly impacts elderly individuals and their caregivers.
- Characterized by increased neuropsychiatric symptoms and behavioral disturbances after sunset.
- Often leads to caregiver distress and challenges in providing consistent care.
Purpose:
- To review the current understanding of sundowning syndrome in the elderly.
- To explore potential pathophysiological mechanisms, including circadian rhythm alterations.
- To discuss existing therapeutic interventions and their unproven effectiveness.
Summary:
- Sundowning involves the aggravation of neuropsychiatric symptoms in elderly individuals as daylight fades.
- Hypotheses suggest a link to circadian rhythm disruption and reduced melatonin production.
- Differential diagnosis includes delirium; current treatments lack definitive efficacy.
Impact:
- Highlights the need for further research into the etiology and effective treatments for sundowning.
- Aims to improve the quality of care for elderly patients experiencing these symptoms.
- Provides a resource for understanding and managing a challenging aspect of geriatric care.
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