# SUNDOWN SYNDROME IN A SKILLED NURSING FACILITY

> **NIH NIH R01** · EMORY UNIVERSITY · 1993 · $86,964

## Abstract

Nocturnal agitation is a major management problem in Alzheimer's Disease
and other dementias.  This descriptive study will use systematic,
intensive, 24-hour behavioral observations and measurements of illumination
and body temperature to investigate a physiological basis for such
sundowning in demented patients in a skilled care nursing facility.  Our
overall hypothesis is that sundowning is physiologically based in
decrements in the circadian timing systems of aged, demented patients.

Agitation will be defined through use of a well-developed, highly reliable
rating scale used by research assistants 96 times per day to determine both
verbal and physical components of agitation.  Sundowning will be defined
operationally as occurring when over 50% of a given patient's agitated
behavior observations occur between sunset and sunrise.  Observations will
be made continuously 24-hours a day over 3 weeks for a total of 1440
observations per patient.  Patients will be studied under conditions of
both relatively high illumination (summer) and relatively low illumination
(winter) with order counterbalanced to control for terminal decline.

On the bases of these observations we will:  1) determine the prevalence of
sundowning; 2) fully describe the temporal pattern of agitated behavior
over the 24 hour day; 3) study apparent seasonal variation in agitation in
dementia (more agitation under lower illumination); 4) determine whether
some demented patients may become more agitated by bright light exposure.

Pilot data to date suggest high statistical power (>.90) for projected
sample size.  These results will map directly into non-pharmacological,
behaviorally based treatments for sundowning in dementia.

## Key facts

- **NIH application ID:** 3122569
- **Project number:** 7R01AG010643-03
- **Recipient organization:** EMORY UNIVERSITY
- **SAM.gov UEI:** S352L5PJLMP8
- **Principal Investigator:** Donald L. Bliwise
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1993
- **Award amount:** $86,964
- **Award type:** 7
- **Project period:** 1991-09-30 → 1994-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/3122569

## Citation

> US National Institutes of Health, RePORTER application 3122569, SUNDOWN SYNDROME IN A SKILLED NURSING FACILITY (7R01AG010643-03). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/3122569. Licensed CC0.

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