How Chess Helps Minimize Sundowning in Dementia Patients

There's long list of symptoms associated with Alzheimer’s disease and other forms of dementia, often include some downright baffling moods, and odd behavior changes.

As the disease progresses, you may notice new patterns in the way a loved one’s symptoms fluctuate throughout the day, and especially in the evenings.

Better known as "sundowning", this increased confusion and restlessness around twilight can be distressing for both patients and caregivers alike.

 The timing of the onset is what gives this group of characteristic symptoms its name. The National Institute on Aging uses the term sundowning, however literature on Alzheimer’s and dementia may also use the terms 

"late-day confusion", "sunset dementia",

and "sundown syndrome".

 Sundowning in dementia patients can occur at any stage of the disease, however it most commonly starts during the middle stages. If sundowning symptoms do occur during the early stages of dementia, they’re typically mild and inconsistent. Sadly, the symptoms of sundown syndrome tend to get worse as dementia progresses and usually never go away completely.

Note that it’s possible for an aging loved one to experience symptoms of sundowning without a dementia diagnosis,

as well. Conversely, not everyone with Alzheimer’s or other dementias will experience sundowning.

 Although dementia confusion can come and go over the course of each day, the exact timing and behaviors of sundowning vary greatly from patient to patient.

It’s important to note that Alzheimer’s disease and other types of dementia don’t present the same way in each person. For some patients, sundowning may actually occur very early in the morning. A single sundowning episode could last anywhere from a few hours to an entire night.

Unfortunately, this dementia behavior prevents many patients and their caregivers from getting adequate rest at night, and sleep deprivation can cause these symptoms to worsen. Therefore, it’s important to understand your loved one’s routines and moods as best as you can to minimize the symptoms of sundowning.

  The emotions that may arise during an episode of "sundowning" include:

Fear, depression, paranoia, anger, and anxiety.
Some behaviors that may arise during an episode of sundowning include:

Emotional outbursts, crying, and yelling, agitation and restlessness, stubbornness, rocking, visual and auditory hallucinations and delusions, hiding things
violent behavior, wandering or pacing, insomnia, and
confusion. 

There is no cure for this yet, but many biopharmas are

working on it. Right now, the best thing we've seen to

work is a steady, daily routine of....chess.

That's right. Focus, problem solving, calm interaction,

the removal of boredom (likely the main benefit, we've seen people's moods change dramatically when they are

no longer bored), and the reduction of daytime sleeping

go a long way to battle this affliction.