On Tue, 19 Aug 2008 09:18:35 -0700, Michael Britt wrote:
>I must admit I've never heard of the term "sundowning". Can
>you explain?
>
>On Aug 19, 2008, at 11:49 AM, Rob Weisskirch wrote:
>> Does anyone know the actual causes of sundowning behavior among the
>> elderly? Is it neurotransmitter related?
The term "sundowning" refers to the increased level of
behavioral agitation shown by some elderly people towards
the end of the day, presumably as the sun sets but it is unclear
to me that there is a clear operational definition for the term.
Depending upon how one defines the term, the increased
level of activity either increases in the late afternoon or
with the occurance of dusk (i.e., the actual setting of the
sun). If the latter, then "sundowning" would vary as a function
of location on the planet and season (earlier in winter,
later in the summer). However, though some believe this
to be a "real" condition, there may be alternative explanations,
such as:
AU: Author
Cohen-Mansfield, Jiska (1)
AF: Affiliation
(1)Research Institute on Aging of the CES Life Communities, Rockville,
MD, US
SO: Source
American Journal of Geriatric Psychiatry. Vol 15(5), May 2007, pp.
395-405
AB: Abstract
Objective: This study investigated the temporal pattern of agitated
behaviors in nursing home residents with dementia and compared it with
temporal patterns of pleasure, interest in the environment, and sleep.
Methods: Trained research assistants recorded direct observations of
agitation and affect by the Agitation Behavior Mapping Instrument and
the Lawton's Modified Behavior Stream for 174 participants from 12
nursing homes. Results: The temporal pattern found for total agitation
showed a gradual increase from the morning until approximately 4 PM
with a decrease thereafter. Only 26% of the sample showed a clear
increase of their agitation in the later hours in comparison to the
morning hours based on our criterion. Pleasure did not show a
consistent pattern, whereas levels of interest peaked during lunch and
dinner times. Conclusions: The results fit with a hypothesis of
fatigue of daytime nursing staff members and disruption during shift
change and may also be partially accounted for by resident fatigue.
Although the literature supports the notion that there is a peak in
overall agitation around 4 PM, the term "sundowning" is not supported
and should be replaced. The phenomenon of increased levels of
agitation during later hours characterizes only a minority of agitated
nursing home residents, albeit the most highly agitated. (PsycINFO
Database Record (c) 2007 APA, all rights reserved) (journal abstract)
-Mike Palij
New York University
[EMAIL PROTECTED]
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