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Case 1 - “I’ve Fallen … and I Can’t Get Up”

Sundowner Syndrome

from Section 1 - Neurocognitive Disorders

Published online by Cambridge University Press:  31 October 2024

Matthew Gibfried  and
George T. Grossberg
Matthew Gibfried
Affiliation:
Saint Louis University School of Medicine, Missouri
George T. Grossberg
Affiliation:
Saint Louis University School of Medicine, Missouri
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Summary

Sundowner syndrome is a common neuropsychiatry syndrome seen in residents of long-term care. Several theories are proposed to explain the pathophysiology and contributing factors. Treatment options are also discussed.

Keywords

sundowner syndromeagitationlong-term carenursing homememory care
Type
Chapter
Information
Clinical Case Studies in Long-Term Care Psychiatry
Navigating Common Mental Health Challenges in Geriatric Care
 , pp. 1 - 4
Publisher: Cambridge University Press
Print publication year: 2024

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References

References

Canevelli, M., Valletta, M., Trebbastoni, A., Sarli, G., Tariciotti, L., & Bruno, G. (2015). Sundowning in dementia: Clinical relevance, pathophysiological determinants, and therapeutic approaches. Frontiers in Medicine, 3. https://doi.org/10.3389/fmed.2016.00073Google Scholar
Grossberg, G. T., Kohegyi, E., Mergel, V., Josiassen, M. K., Meulien, D., Hobart, M., Slomkowski, M., Baker, R. A., McQuade, R. D., & Cummings, J. L. (2020). Efficacy and safety of brexpiprazole for the treatment of agitation in Alzheimer’s dementia: Two 12-week, randomized, double-blind, placebo-controlled trials. The American Journal of Geriatric Psychiatry, 28 (4), 383–400.CrossRefGoogle ScholarPubMed

Further Reading

Ahmad, F., Sachdeva, P., Sarkar, J., & Izhaar, R. (2022). Circadian dysfunction and Alzheimer’s disease: An updated review. Aging Medicine, 6 (1), 71–81. doi: 10.1002/agm2.12221. PMID: 36911088; PMCID: PMC10000289.CrossRefGoogle ScholarPubMed
Carrarini, C., Russo, M., Dono, F., Barbone, F., Rispoli, M. G., Ferri, L., Pietro, M. D., Digiovanni, A., Ajdinaj, P., Speranza, R., Granzotto, A., Frazzini, V., Thomas, A., Pilotto, A., Padovani, A., Onofrj, M., Sensi, S. L., & Bonanni, L. (2020). Agitation and dementia: Prevention and treatment strategies in acute and chronic conditions. Frontiers in Neurology, 12. https://doi.org/10.3389/fneur.2021.644317Google Scholar
Desai, A., & Grossberg, G. (2018). Psychiatric Consultation in Long-Term Care. A Guide for Healthcare Professionals. 2nd ed. (Cambridge University Press.)Google Scholar
Guu, W., & Aarsland, D. (2022). Light, sleep–wake rhythm, and behavioural and psychological symptoms of dementia in care home patients: Revisiting the sundowning syndrome. International Journal of Geriatric Psychiatry, 37 (5). https://doi.org/10.1002/gps.5712CrossRefGoogle ScholarPubMed
Lin, L., Huang, Q. X., Yang, S. S., Chu, J., Wang, J. Z., & Tian, Q. (2013). Melatonin in Alzheimer’s disease. International Journal of Molecular Sciences, 14 (7), 14575–14593. doi: 10.3390/ijms140714575. PMID: 23857055; PMCID: PMC3742260.CrossRefGoogle ScholarPubMed
Menegardo, C. S., Friggi, F. A., Scardini, J. B., Rossi, T. S., Vieira, S., Tieppo, A., & Morelato, R. L. (2019). Sundown syndrome in patients with Alzheimer’s disease dementia. Dementia & Neuropsychologia, 13 (4), 469–474. https://doi.org/10.1590/1980-57642018dn13–040015CrossRefGoogle ScholarPubMed
Sharma, A., Sethi, G., Tambuwala, M. M. A., Aljabali, A. A., Chellappan, D. K., Dua, K., & Goyal, R. (2021). Circadian rhythm disruption and Alzheimer’s disease: The dynamics of a vicious cycle. Current Neuropharmacology, 19 (2), 248–264. https://doi.org/10.2174/1570159X18666200429013041CrossRefGoogle ScholarPubMed
Todd, W. D. (2019). Potential pathways for circadian dysfunction and sundowning-related behavioral aggression in Alzheimer’s disease and related dementias. Frontiers in Neuroscience, 14. https://doi.org/10.3389/fnins.2020.00910Google Scholar

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