Hello, dear friends.

This is Dr. Charles from PHI Preventive Health Institute, where we share practical health lessons to help you live a healthier and happier life.

Have you ever noticed that an older loved one with memory problems seems much more confused, restless, or agitated in the evening?

Perhaps they wander around the house, become suspicious, shout, or struggle to recognize family members after sunset.

Many families think this is simply part of aging or dementia.

But sometimes, there is more to the story.

What Is “Sundowning”?

Many people living with dementia experience a pattern called sundowning.

As the day comes to an end, they may become:

  • More confused

  • Restless or anxious

  • Irritable

  • Unable to sleep

  • More likely to wander or become agitated

Experts believe this may happen because the brain becomes tired after a full day, lighting becomes dimmer, and the body’s normal sleep-wake cycle is disrupted.

But Sometimes It’s Not Just Dementia

If someone with dementia suddenly becomes much worse over a few hours or days, it may be caused by another medical problem that needs urgent treatment.

This sudden change is sometimes due to a condition called delirium, which is different from dementia and can often improve when the underlying cause is treated.

Common Medical Problems That Can Cause Sudden Confusion

Infections

Older adults may become confused because of infections such as:

  • Malaria

  • Urinary tract infections

  • Pneumonia

In some cases, confusion may appear before fever or other obvious symptoms.

Dehydration and Body Imbalances

The brain needs the right balance of fluids and nutrients to function properly.

Problems such as:

  • Dehydration

  • Low or high blood sugar

  • Low sodium levels

  • Kidney problems

  • Liver disease

can all make confusion much worse.

Medicines and Herbal Mixtures

Some medications or herbal products can affect the brain, especially in older adults.

These include:

  • Sleeping tablets

  • Strong pain medicines

  • Taking many medicines together

  • Unregulated herbal mixtures

Always tell your healthcare provider about everything the person is taking, including traditional remedies.

Warning Signs That Need Immediate Medical Attention

Seek medical care as soon as possible if your loved one suddenly develops:

  • A rapid increase in confusion

  • Hallucinations or seeing things that are not there

  • Extreme sleepiness or unusual agitation

  • Refusal to eat or drink

  • A sudden decline over hours or a few days

These symptoms should never be ignored

Why Early Treatment Matters

The encouraging news is that many causes of sudden confusion can be treated.

For example:

  • Treating malaria may improve alertness

  • Correcting dehydration can restore mental function

  • Treating an infection may reduce confusion

  • Adjusting medications can improve thinking and behavior

The sooner the cause is identified, the better the chance of recovery.

Final Thoughts

If a person with dementia suddenly becomes much more confused or behaves very differently, do not assume it is simply the disease getting worse.

Sometimes, the brain is signaling that another medical problem needs attention.

Remember:

  • Sudden changes deserve urgent evaluation.

  • Not every worsening of dementia is permanent.

  • Early treatment can make a remarkable difference.

Pay attention to these warning signs, seek help promptly, and never hesitate to ask questions. Acting early could help your loved one return to their usual level of function.

📞 PHI Preventive Health Institute
Call / WhatsApp: +233 20 872 0347