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The term “nocturnal syndrome” (or twilight) is sometimes used to describe the tendency of people with dementia to feel more confused in the late afternoon and evening.

First, I must emphasize that the term “afternoon syndrome” is an oversimplification that may include various behaviors in many different situations.

When assessing behavioral changes in dementia, it is better to hear a full and accurate account of what the person was doing at the time than to accept that they are suffering from a sunset.

This group of behaviors often described as “afternoon syndrome” usually includes (but is not limited to) Confusion, anxiety, agitation, pacing, and following others.

It can manifest differently depending on the degree of dementia, the individual’s personality and past behavior patterns, and the presence of specific triggers.

So why do these behavioral changes tend to occur at certain times of day? What do we do when these things happen to our loved ones?

less sensory information

We all interpret the world through the information our brain receives through our five senses.


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As night falls, the amount of sensory information that helps people with dementia interpret the world decreases.

The most important of which are vision and hearing.

Imagine the difficulty you would experience if you were asked to perform a complex task in a dark room.

People with dementia also rely on sensory information to understand and correctly interpret their environment.

As the light fades at the end of the day, so does the amount of sensory information available to help people with dementia interpret the world.

The effect on the brain, which has difficulty integrating sensory information, can be dramatic, leading to increased confusion and unexpected behavior.

cognitive fatigue

We’ve all heard that we only use a fraction of our brain power, and indeed, we have more brain power than most everyday tasks typically require.


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Our brains have more power than they need for everyday tasks.

this “cognitive reserve” It is used when we have to perform complex or stressful tasks that require more mental effort.

But what if you don’t have much cognitive reserve?

Changes that eventually lead to Alzheimer’s symptoms may begin to develop until 30 years ago these symptoms appear.

At that time, simply put, This situation depletes our cognitive reserves.

We only experience the first symptoms of Alzheimer’s and other forms of dementia when the damage done is so severe that our brains cannot compensate.

So by the time someone first shows early symptoms of dementia, most of the damage has already been done.

Cognitive reserve is lost and symptoms of memory loss eventually become apparent.

As a result, people with dementia require more mental effort than most of us throughout the day.

After a long day of demanding tasks that require high mental effort and focus, we all feel cognitively fatigued, drained, and even a little irritable.

People with dementia must exert similar mental effort to complete daily life.

So it’s not surprising that they tend to feel cognitively exhausted after hours of mental exertion in order to survive (often in unfamiliar places).

What should I do if this happens to someone I love?

lighting room

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It is very important to keep the room well lit in the evening and at night.

Homes for people with dementia should Sufficient lighting Helping people with dementia as the sun goes down in the afternoon and evening Integrate and interpret sensory information.

A take a nap After lunch can help relieve cognitive fatigue at the end of the day. This gives the brain a chance to “recharge”.

However, there is no substitute for a more complete evaluation of other possible causes of the conduct disorder.

unmet needs such as hunger or thirst,exist painthis depressedhe boring the waves Lonely Contributions can be made, as well as stimulants such as caffeine or sugarif consumed very late in the day.

The oversimplified term “afternoon syndrome” often describes behaviors that are complex and whose causes are often individual and interrelated.

As often happens in medicine, a particular set of symptoms is best managed by gaining a better understanding of their causes.

*Steve Macfarlane is Director of Clinical Services at the Australian Dementia Support Center and Associate Professor of Psychiatry at Monash University.

This article was published on The Conversation and is reproduced under a Creative Commons license.You can read the original English text here.

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