A person may become distressed and even experience hallucinations or delusions during this period
A psychologist has delved into an overlooked sign of dementia and exactly what patients can do to manage it. The symptom is thought to be particularly noticeable in the afternoon and may initially seem difficult for loved ones to understand.
Dr Kellyn Lee, CEO of The Dementia Care Hub and Visiting Academic at the University of Portsmouth, explained in a TikTok during 2025: “So, this can happen at any time of day, but what we see a lot with people living with dementia is that it can happen in the afternoon.”
She then added: “So, what I would be looking at is this would be, again, a symptom of anxiety and agitation and maybe increased confusion.” Dr Lee is referring to a phenomenon known as ‘sundowning’, which describes more unpredictable behaviour in dementia patients after midday, towards the evening.
Within this period, a person may become particularly distressed while potentially experiencing delusions or hallucinations as well. Although the exact causes are not fully understood, the Alzheimer’s Society indicates that it is not necessarily related to sunset.
Instead, sundowning is more commonly linked to a person’s unmet needs in that moment. This may include the following:
- Mood disorders, including anxiety and depression
- Hunger, pain or other unmet physical needs
- Disturbed hormone levels
- Side effects of prescribed drugs
- Sensory impairment, including sight loss
- Disturbance to the person’s ‘body clock’ caused by damage to the brain
- Overstimulation during the daytime
- Overtiredness
- Lack of exposure to sunlight
- Lack of interaction with other people or carers (if relevant)
“Sundowning can happen at any stage of dementia but is more common during the middle stage and later stages,” further advice from Alzheimer’s Society adds. It then continues: “Think whether something that’s happened during the day has affected them. If they seem agitated, try to calm them by distracting them, perhaps talking about a favourite memory or event they enjoy thinking about.”
If you are concerned that your loved one is experiencing sundowning, Dr Lee also recommended noting the symptoms at different times of day. In her past video explanation, she continued: “So, what I would be looking at doing is noting down when this is happening and what’s happening. There are tablets that can be used, such as lorazepam.
“Absolutely these drugs are drugs that need to be taken with caution because they are highly addictive. So, some GPs may not want to prescribe them.
“However, I think we really need to balance the risk of addiction compared to the fact the person has dementia.”
Other possible symptoms of dementia
Dementia is an umbrella term encompassing various health issues, including Alzheimer’s disease, all marked by a progressive decline in brain function. NHS statistics show that over 944,000 people throughout the UK are currently living with dementia.
Symptoms of dementia vary depending on the type, but early signs often include:
- Mood changes
- Difficulty concentrating
- Finding it hard to carry out familiar daily tasks, such as getting confused over the correct change when shopping
- Memory loss
- Struggling to follow a conversation or find the right word
- Being confused about time and place
NHS guidance adds: “These symptoms are often mild and may get worse only very gradually. It’s often termed ‘mild cognitive impairment’ (MCI) as the symptoms are not severe enough to be diagnosed as dementia.
“You might not notice these symptoms if you have them, and family and friends may not notice or take them seriously for some time. In some people, these symptoms will remain the same and not worsen. But some people with MCI will go on to develop dementia.
“Dementia is not a natural part of ageing. This is why it’s important to talk to a GP sooner rather than later if you’re worried about memory problems or other symptoms.”