Sundown syndrome and symptoms of anxiety and depression in hospitalized elderly

Marcello Weynes Barros Silva, Rilva Lopes Sousa-Muñoz, Heitor Cabral Frade, Priscilla Alencar Fernandes, Andrêssa de Oliveira Magalhães

Sundown syndrome is characterized by the sudden appearance of neuropsychiatric symptoms such as agitation, confusion and anxiety in a chronologic fashion, usually during late afternoon or early evening. To evaluate the prevalence of sundown syndrome in university hospital wards and its relationship with anxiety/depression symptoms, cognitive decline, and clinical and demographic variables. We evaluated 70 patients admitted to the Lauro Wanderley University Hospital (HULW), João Pessoa-PB, Brazil. Data collection instruments were the Confusion Assessment Method (CAM), the Mini-Mental State Exam (MMSE) and the Hospital Anxiety and Depression Scale (HADS). Mean patient age was 68.4±6.4 years, 55.7% were male, 67.1% were illiterate or had incomplete primary education. It was observed that 14.3% of patients had delirium, 15.7% had cognitive deficits, while 21.4% and 18.6% had anxious and depressive symptoms, respectively. The age of patients with delirium (71.9±8.7) was significantly higher than those without (67.8±5.8). At 95% confidence, there was a significant difference in the groups with and without delirium for the MMSE and HADS-D scales. We verified the occurrence of delirium compatible with the sundown syndrome and associated with depressive symptoms and cognitive deficit, with no apparent relationship with infectious processes or fever, number of drugs used, hospital stay or anxious symptomatology.