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Here's how to distinguish "sundowning"—agitation or confusion later in the day in dementia patients—from typical aging, from doctors who treat older adults.
Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
The most common causes of drug induced acute confusion are dopaminergic drugs (used for the treatment of Parkinson's disease), diuretics, tricyclic, tetracyclic antidepressants and benzodiazepines or alcohol. The elderly, and especially those with pre-existing dementia, are most at risk for drug induced acute confusional states. [8]
Sundowning, or sundown syndrome, [1] is a neurological phenomenon wherein people with delirium or some form of dementia experience increased confusion and restlessness beginning in the late afternoon and early evening.
More likely in the elderly with pre-existing declining mental functions, termed mild cognitive impairment (MCI). [13] MCI is a transitional zone between normal mental function and evident Alzheimer's disease or other forms of dementia. It is insidious, and seldom recognized, except in retrospect after affected persons are evidently demented.
The third reason is the "memory self-efficacy," which indicates that older people do not have confidence in their own memory performances, leading to poor consequences. [17] It is known that patients with Alzheimer's disease and patients with semantic dementia both exhibit difficulty in tasks that involve picture naming and category fluency.
Causes vary between the different types of disorders but most include damage to the memory portions of the brain. [ 6 ] [ 7 ] [ 8 ] Treatments depend on how the disorder is caused. Medication and therapies are the most common treatments; however, for some types of disorders such as certain types of amnesia , treatments can suppress the symptoms ...
It is one of the most common causes of disability among the elderly but can develop before the age of 65 when it is known as early-onset dementia or presenile dementia. [ 276 ] [ 277 ] Less than 1% of those with Alzheimer's have gene mutations that cause a much earlier development of the disease, around the age of 45, known as early-onset ...