Sundowning and delirium

Q: Sundowning is a form of Delirium?

A) True

B) False

Answer: B

It is very hard to distinguish between sundowning and delirium. Unfortunately, despite known for decades, sundowning remained a poorly understood phenomenon manifested by behavioral deterioration in the evening hours. It usually occurs in elderly, demented, and institutionalized patients. The most plausible explanation is the impaired circadian regulation, superimposed on institutional environment like shift changes.

Patients with sundowning usually have an established pattern and no obvious medical illness. Any new pattern in a previously unknown sundowning should be presumed as delirium.

#psychiatry

#neurology

References:

1. Khachiyants N, Trinkle D, Son SJ, Kim KY. Sundown syndrome in persons with dementia: an update. Psychiatry Investig. 2011 Dec;8(4):275-87. doi: 10.4306/pi.2011.8.4.275. Epub 2011 Nov 4. PMID: 22216036; PMCID: PMC3246134.

2. Canevelli M, Valletta M, Trebbastoni A, Sarli G, D'Antonio F, Tariciotti L, de Lena C, Bruno G. Sundowning in Dementia: Clinical Relevance, Pathophysiological Determinants, and Therapeutic Approaches. Front Med (Lausanne). 2016 Dec 27;3:73. doi: 10.3389/fmed.2016.00073. PMID: 28083535; PMCID: PMC5187352.