Jul 07, 2023 19:00:00

What is the ``dusk syndrome'' in which the symptoms of dementia worsen from evening to night? How should the people around me deal with it?

Symptoms of dementia and Alzheimer's disease are variable throughout the day and tend to worsen in the evening and night in many patients. This phenomenon is called `` (PDF file)

twilight syndrome '', and Steve, a psychiatrist at Monash University , explains why twilight syndrome occurs and how people around him should support patients. Associate Professor McFarlane explains.

What is 'sundowning' and why does it happen to many people with dementia?
https://theconversation.com/what-is-sundowning-and-why-does-it-happen-to-many-people-with-dementia-208005

First, Mr. McFarlane points out that 'twilight syndrome' is a term that encompasses a wide variety of situations and actions, and that it should be noted that it simplifies the problem when used. On top of that, twilight syndrome generally includes changes in states and behaviors such as confusion, anxiety, agitation, wandering, and chasing familiar people, and the degree and personality of dementia, past behavior patterns, etc. It explains that the content will change depending on.

McFarlane cites two main reasons why dusk syndrome occurs in many dementia patients.

◆1: Decrease brightness
People interpret the world around them from information that enters their brains through their five senses, the most important of which are sight and hearing. Therefore, if a complex task is performed in a dark room, it is less efficient and more likely to make mistakes than if it is performed in a bright room.

People with dementia and Alzheimer's disease also rely on their senses to correctly interpret their environment, but these people have a reduced ability to integrate sensory information in their brains. The difference is that there is As the environment gets darker towards the end of the day, less sensory information is available to people with dementia, resulting in confusion and unexpected behavior. These are collectively known as twilight syndrome, McFarlane explained.

◆2: Increased cognitive fatigue
Many people spend their days with cognitive capacity to spare, and it is rare that they run out of cognitive capacity just by doing everyday tasks. Therefore, even if you are faced with a complex problem or placed in a stressful situation, you can overcome it by making full use of your surplus cognitive ability. Decreased cognitive ability is restored by rest and sleep, and the next day you can think about things with a clear head again.

However, in patients with dementia and Alzheimer's disease, whose cognitive abilities have been declining for many years, the brain can no longer secure extra cognitive abilities, so problems such as forgetfulness and strange behavior occur in daily life. In addition, these patients require more mental effort to live their daily lives than normal people, and they are more likely to deplete their cognitive abilities during the day.

Ordinary people also tend to make more careless mistakes and become emotionally unstable when they are overworked and tired. McFarlane pointed out. Therefore, after a certain amount of time has passed since waking up, the symptoms of dementia tend to worsen.

◆ How should the people around you deal with it?
If someone close to you develops dementia, there are several things you can do to prevent dusk syndrome. First of all, it is possible to prevent the occurrence of twilight syndrome by turning on bright lights early in the afternoon and keeping the room bright until you go to bed, as the surrounding darkness is one of the causes of twilight syndrome. Also, since cognitive abilities are likely to be exhausted if patients stay up from morning to night, it may be effective to reduce cognitive fatigue by having them take a nap after lunch, McFarlane said. says.

However, since Twilight Syndrome is a loose umbrella term for a range of situations and behaviors, it is most important to work closely with the individual patient to determine the underlying cause. For example, there are cases where symptoms worsen due to factors such as hunger, thirst, pain, depression, boredom, and loneliness, so removing these root causes is the most important way to prevent dusk syndrome. That's what McFarlane concluded.