Sundowning behavior is characteristic of which condition?

Sundowning behavior is characteristic of which condition?

• A. Depression
• B. Dementia
• C. Sleep deprivation
• D. Delirium

Answer: (D)

Sundowning is the pattern of increasing confusion, agitation, and sometimes disorientation that tends to occur in the late afternoon or evening. This nocturnal surge in symptoms is most closely associated with delirium in older adults, because delirium is defined by an acute, fluctuating disturbance of attention and cognition that can worsen as the day ends when the sleep–wake cycle becomes more disrupted and medical or environmental stressors are more pronounced. While dementia can include evening worsening as part of a chronic cognitive decline, the defining feature in delirium is the acute, fluctuating course with nocturnal worsening, which is why this pattern is most characteristic of delirium. Depression can cause diurnal mood variation and sleep problems, and sleep deprivation can impair function, but they do not produce the distinct, acute nocturnal cognitive fluctuation seen with delirium. If you’re evaluating suspected delirium, look for abrupt onset, fluctuating levels of consciousness, inattention, and an identifiable precipitating factor such as infection, dehydration, medication effects, or metabolic disturbances.

Sundowning is the pattern of increasing confusion, agitation, and sometimes disorientation that tends to occur in the late afternoon or evening. This nocturnal surge in symptoms is most closely associated with delirium in older adults, because delirium is defined by an acute, fluctuating disturbance of attention and cognition that can worsen as the day ends when the sleep–wake cycle becomes more disrupted and medical or environmental stressors are more pronounced. While dementia can include evening worsening as part of a chronic cognitive decline, the defining feature in delirium is the acute, fluctuating course with nocturnal worsening, which is why this pattern is most characteristic of delirium. Depression can cause diurnal mood variation and sleep problems, and sleep deprivation can impair function, but they do not produce the distinct, acute nocturnal cognitive fluctuation seen with delirium. If you’re evaluating suspected delirium, look for abrupt onset, fluctuating levels of consciousness, inattention, and an identifiable precipitating factor such as infection, dehydration, medication effects, or metabolic disturbances.