WEEKLY, SEASONAL AND GEOGRAPHIC PATTERNS IN HEALTH CONTEMPLATIONS ABOUT SUNDOWNING BEHAVIORS

Abstract

AbstractSundowning behaviors (agitation later in the day) are common in older adults with dementia. The underlying etiology for these behaviors is unclear; possibilities include increased caregiver fatigue at the end of the day and disruption of circadian rhythms by both age and neurodegenerative illness. Daily internet search query data was obtained from Google Trends (2005 to 2016 inclusive). Circumseptan (weekly) patterns were determined by wavelet analysis, seasonality was determined by the difference in search volumes between winter (December, January and February) and summer (June, July and August) months and geographic associations between percent sunny days and latitude were done on a state-by-state basis. ‘Sundowning’ searches showed a significant increase at the end of the weekend with activity 10.9 ± 4.0 percent higher on Sunday as compared to the rest of the week. Search activity showed a seasonal pattern with search activity significantly highest in the winter months (36.6 ± 0.6 versus 13.7 ± 0.2, p < 0.001). State-by-state variations in ‘sundowning’ searches showed a significant negative association with increasing mean daily sunlight (R2 = 0.16, β = -0.429 ± 0.149, p = 0.006) and showed a positive association with increasing latitude (R2= 0.38, β = 0.648 ± 0.122, p < 0.001). Interest in ‘sundowning’ is highest after a weekend, a time when external caregiver support is reduced. ‘Sundowning’ searches also were highest in winter, in states with less sun, and states at a more northerly latitudes, supporting disrupted circadian rhythms as another contributing factor to these behaviors.