Aging Clinical and Experimental Research

, Volume 28, Issue 3, pp 383–392 | Cite as

“Sundowning” as a biological phenomenon: current understandings and future directions: an update

  • Gowrishankar GnanasekaranEmail author


The clinical phenomenon of early evening disruptive behavior also called “Sundowning” in elderly patients has been largely reported in the medical literature without a consistent diagnosis and criteria to define this phenomenon. The current understandings of sundowning are incomplete and current treatment strategies have relied heavily on use of antipsychotic medications, despite side effects and limited evidence to justify their use. A comprehensive understanding of the biogenesis of this phenomenon and mechanistic changes from oxidative pathways may provide novel information on completing the sundowning puzzle. Future studies could examine the utility of natural factors in reviving neuronal energy loss and altering the oxidative pathways might be safe and additional options in development of treatment models for this behavioral disorder.


Sundowning Oxidation Sunlight Treatments 


Compliance with ethical standards

Conflict of interest

Author has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Division of Geriatrics and Palliative Care, Department of Internal MedicineThe University Hospitals Case Medical CenterClevelandUSA

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